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—'Aug . 5 . 2002 3: 23PM CONDOP FARTH TECHNOLOGIES <br /> No•0106 P • 2/2 <br /> meq . aV 7 Cie LGG NuMHER <br /> SAN JOAQUIN COUNT YFUSUC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION Wr <br /> ?*7 <br /> 304 EAST WEBER AVENUE, THIRD FL OOR <br /> SI'OCKTON GA 95202 <br /> . (209) 468-3.420 <br /> PUBLICRECORDS RELEASE APPUCATI N <br /> APPUCANr /�/[eNL�I�V _�YG !Ilr?F HUsw AGeNCY�c� v�rr E�Sr-} -T �1�l 10 �CCt 1 eS <br /> ADDRESS <br /> PHONE aL-<-l��"L1�>� ) FAC31Mllk <br /> TENTATIVE'APPAWYMEW DATE TIDE <br /> (Ple a9TMe tG Gl)4ioegf �aaPR s,rbmuwn <br /> Q CHECK HOXTO EXPEDFM REQUEST-587.00 F/EEA/-R£QUBST PRC 1 3 B SINESS DAYS <br /> SIGNATURE OF APPLICANT /�// Q -Ie DATE OYZgS'IOZ <br /> F7L AAAR1='35 THLS=E EHD STAFF USW CNLY <br /> PROGRAM EL3IENTS SEARCH <br /> ,70 u eN ftRE7'00d ,0N <br /> ,20( <br /> . T <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK{USI) CLEANUP 517E(LOP) ❑ HOUSING ABATEMENT ,�SOLID WASTE FACRITY <br /> ❑ FOOD FACILry �[ SCUD WASTE WHICLE <br /> OTHER CLEANUP SITE(NONI.OP) C3 DAIRY <br /> JIB UNDERGROUND TANK(MONrrOR1NG REMOVAL) ❑ DOG KUYNEL <br /> ❑ CHICKEN RANCH ❑ PKG TRF-A7MENT PLANT <br /> �( HAZARDOUS WASTB GENERATOR ❑ MOTEIIFI(7T,EL ❑ PUMPER TRUCKIYARAICH9MTOILETS <br /> TIERED TIERPERMrI'rED FACILITY ❑ P60LSPA • - 0 LAND USF APPLIGA•nON SITES <br /> ❑ TATTOC/1QODYPEIR0NG ❑ PUBLIC WATERSY^TEM ❑ OZHER(PLEASESPECIFYABUYE) <br /> MEDICAL WASTE FACILITY <br /> 1_ List up to teaddresses in the space above_ Select the type(s) of files from the list above by checking <br /> n <br /> the appropriate box(es), At least one file type MUST be selected. Fax to (209) 46�t-o138or rna- —l1��Q <br /> address indt"ted above. <br /> 2. EtiD will notify the applicant if any EHD riles exist An appointment far review will be confirmed <br /> approximately five business days but no later than ten (10) days after receipt of applTcat)on. The file* <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. Anew <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 587.00 deposit prior to review. <br /> 5 "TENTATIVE appointment dates must be confirmed with EHI) staff. <br /> 6, Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE _.. ... <br /> TIME °� <br />