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Aug 25 2003 I,20PM, CO. EARTH TECHNOLOGIES No•4748 P. I/I r . K—r ;`r< NATE RWaVEO ENO LOG NilyeEe SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES ENVIRONMENTAL HEALTH DIVISION 'WC 304 EAST WEBER AVENUE, THIRD FLOOR r� � c ��'; STOCXTON CA 95202 (209)468-3420 NO PUBLIC RECORDS RELEASE APPLICATION APPL'CANT p_((��$USINESS/AGENCY cone zr �r��T.� h n ADDRESS �'OV J.Y .S� I _. Y7'1..P 1 e,-4 11._7 PHONE zl� FACSIMILE -^-3G- �• TENTATIVE' APPOINTMENT DATE 2p U TIME (Pleaaa give 7 to 10 business d4.0 from date of appllcadon submittal) pe't ICHECK BOX70 EXPEDITE RE4UES7-;87.00 FEERE4UESTPRCCES5ED IN 3 BUSINESS pAY3 � �-1,V?j \ SIGNATURE OF APPLICANT 1�+� -� DATE q, -03 c T FILE ADDRESS THIS SINE EHD STAFF USE ONLY t 1!5 r PROGRAM E142AU,NTS SEARCH - "� UNDERGROUND TANK 01ST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENTj�'SCUD WASTE FACUJTY r OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACR.ITY 'Jid' SCUD WASTE VEHICLE ,y UNDCRGROUND TANK (MONITORINGIMMOVAL) ❑ DOG KF- ❑ DAIRY 9 y� HAZARDOUS WASTE GENERATOR Cl CHICKEN RANCH C] PKG TREATMENT PLANT TIERED PERMITTED FACILITY ❑ MOTEUHOTEL ❑ PUMPER TkUCK/YARD/CHEM 701LEi5 TATTOOIBODY PEIRCING C) POCL/SPA ❑ LAND USE APPLICATION SMS MEDICAL WASTE FACILITY PUBLIC WATER SYSTEM ❑ OTHER (PLEASE SPEC1FrA00VE) 1• List up to ten addresses in the space above- 'Select the type(s) of files from the list above by checking the appropriate box(es), At least one file type MUST be selected- Fax to (209) 4134-0138 or mall to the address indicated above. 2. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately five business days but no later than ten (10) days after receipt of application, The files will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. 3- A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may be submitted when the file is available. 4. Any file not returned in the same Condition as released will be reorganized by EHD staff at the expense of the applicant Future file reviews by the same applicant may require a $87.00 o)St{gpror't�rel y§r 5. 'TENTATIVE appointment dates must be•confirmed with EHD staff. a 6. Applications received after 3:00 pm will be processed the next business day. CONFIRMED APPOINTMENT DATE TIME a _ ► -A A L►i�■s�� • I<.. s1 --RUN M..te ENVIRONMENTALDIVISION NM11 "� UNDERGROUND TANK 01ST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENTj�'SCUD WASTE FACUJTY r OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACR.ITY 'Jid' SCUD WASTE VEHICLE ,y UNDCRGROUND TANK (MONITORINGIMMOVAL) ❑ DOG KF- ❑ DAIRY 9 y� HAZARDOUS WASTE GENERATOR Cl CHICKEN RANCH C] PKG TREATMENT PLANT TIERED PERMITTED FACILITY ❑ MOTEUHOTEL ❑ PUMPER TkUCK/YARD/CHEM 701LEi5 TATTOOIBODY PEIRCING C) POCL/SPA ❑ LAND USE APPLICATION SMS MEDICAL WASTE FACILITY PUBLIC WATER SYSTEM ❑ OTHER (PLEASE SPEC1FrA00VE) 1• List up to ten addresses in the space above- 'Select the type(s) of files from the list above by checking the appropriate box(es), At least one file type MUST be selected- Fax to (209) 4134-0138 or mall to the address indicated above. 2. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately five business days but no later than ten (10) days after receipt of application, The files will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. 3- A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may be submitted when the file is available. 4. Any file not returned in the same Condition as released will be reorganized by EHD staff at the expense of the applicant Future file reviews by the same applicant may require a $87.00 o)St{gpror't�rel y§r 5. 'TENTATIVE appointment dates must be•confirmed with EHD staff. a 6. Applications received after 3:00 pm will be processed the next business day. CONFIRMED APPOINTMENT DATE TIME