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Mar • 10 2003 12 : 25PM CONDOR EARTH TECHNOLOGIES <br /> \TE NeCE1VED <br /> I; �r" �AN JOgt�(1IN COUNTYPUBLIC HEALTH Sa;F�VICES <br /> ` ' ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEER AVENUE,THIRD FLOOR I PQ <br /> MAR 1 0 2003 S7pGt(TON CA 95202 0 <br /> (209)468-3420 <br /> E <br /> ff4 VMENT NEA BLIC RECORDS RELEASE APPLICATION <br /> APPLICANT /Y(CF'f191GL AfW/✓Erj�F7 SUSINESSIAGENCY AJpuK <br /> ADDRESS (A/FST`C-I/.CiK.i 4v1'rLC cUL.TOn� L-rC_.LSLO6 <br /> PHONE 201• 60I-Y97-7— <br /> FACSIMILE 2.0q. !q f,.0S3G <br /> TENTATIVE' APPOINTMENT DATE TIME <br /> (Plass°slve 7 to'D hualness days from dale of apptication sabmigat)' I — �� <br /> CHECK BOX TO EXPEDITE REQUEST-S8 .00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS N n I4 a1 <br /> L/ <br /> SIGNATURE OF APPLICANT - DATE <br /> PILE ADDRESS THIS SIDE EHD STAT 1=USE ONLY <br /> PROG&AM ELEMENTS SEARCH T <br /> tINI Dn/ RO I — <br /> ulo.a Ro t.,t j -- <br /> 6 oN Qol <br /> 3 il IJ Lo N - <br /> i <br /> J l 2s o <br /> t 1318 A,R <br /> 1 S to — <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> )2. UNDERGROUND TANK(UST) CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT IKE SOLID WASTG;FACLLITY <br /> ;R OTHER CLEANUP SITE(N ON-LOP) ❑ FOOL)FACILITY ❑ SOLID WASTE YIEIACLE <br /> R�UNDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> �-HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> TIERED PERMITI-ED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCIGTARO/CHEM TOILETS <br /> ❑ TATTOO/BODY PEIRCING ❑ Pool-aiPA -. ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEAS.E SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above, Select the type(s) Of files front the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to (-209) 464_()138 or mail to the <br /> addres2 ind1cpted above <br /> 2• EHD will notify the applicant if any EHD files exist. An appointment for review will he confirmed <br /> approximately five business days but no later than ten (10) days after receipt of applicatlon. The files <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 avallable for review. P,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 /> 3. Applications received after 3:00 pm will be processed the next business day, <br /> , ONFIRMED APPOINTMENT DATE TIME <br /> )ATE CONFIRMED PHONE FAX INITIALS <br />