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Au5 . 12. 2002 12:01PM CONDOR EARTH TECHNOLOGIES No•0818 P. •1/1 <br /> 1\j0nT5 RE[gVEO - �55ww <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVIaL <br /> )(C <br /> ENVIRONMENTAL HEALTH DIVISION <br /> Of 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 AUG 12 2002 <br /> (209) 468-3420 NVIRONMENT HEALTH <br /> PUBLIC RECORDS RELEASE APPLICATION pFpA <br /> APPLICANT— LL �e_•,'�BUHINESSIAGENCY ADDRESS- <br /> Lt Lt ,A s� �'i►-�1�� 4��i 1� 2 <br /> PHONE ... . 'FACSIMILE <br /> TENTATIVE*APpojMVFNT DATE TIME <br /> (Please give 7 to 10 busdbM d to f13 <br /> Ti000n sebm(ttan <br /> CHECK BOx TO ExPED17E REQUEST- / Q PRTEUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE /a o2 <br /> FILE ADDRESS - THIS SIDE EHD STAFF USE ONLY <br /> \, PROGRAM ELEMENTS SEARCH <br /> StoV <br /> V5 u ro r t. <br /> V . <br /> ns <br /> E.� 't .. <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT I4 SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOp) Cl F4000 FACILITY 09P SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(NONITOWNG i EAIOVAL) ❑ DOG KENNEL a DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKENRANCH ❑ PKG TREATMENT PLANT <br /> I.T TIERED PERYn-TED FACiLn'Y ❑ MOTEIIHOTEL ❑ PUMPER TRUCKIYARD/CHEM TOILETS <br /> ❑ TATTOOIBODY FORCING Cl POOLISPA ❑ LAND USEAPPLICATION SITES <br /> (A MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above. Select the type(S)of flies from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to (209)464-0128 or mall-to the <br /> address indicated above. <br /> 2. EHD will notify the applicant if any EHD flies exist An appointment for review will be confirmed <br /> approximately five business days but no later than ten (10) days after receipt of application. The flies <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new <br /> application may be submitted when the file is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense <br /> of the applicant Future file reviews by the same applicant may require a$87.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> nATF I-nmriD01YCrl nunur e-�v .......... .. <br />