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DEC -13-2004 12:53 CONDOR EARTH TECH 209 532 0773 P.01i0' PATE Rt;CE1VED f}!p LOG NUN SAN JOAQUIN COUNTY E+ NVM0N1NMNT'.AL ITF AITH DEPARTm= DEC 1 ;3 2004 304 E Weber Ave 3d Floor Stockton, CA 95205 (209) 468-3420 Fax: (2-09) 464-0138 Web: www.co,san-joaquin.ca_us/ehd = PUBLIC RIEC010S RELEASE APPLICATION APPLICANT; 1-"1i�`SP "^1�� BUSIN,ESSIAGENCY: � d ADDRESS: i/' " a F�%1,l 20?4-_ v-," �f 11 >4 - C�C'� `tet/ PHONE( I — �G FACSCMILE: c - Q t` TE,NN�� TAT' APPowmENT DATE I JJece Urz�t (Please allow 10 business days from date of appl!cat(on subrnittal) CHECK SOX To E)a-rxr ET- $93.00 FEE --REQUEST PROCESSED IN 3 BUSINESS DAYS SIGNATURE OF APPLICANT DATE I 1��-07444 ENVIRONMENTAL HEALTH DEPAI' TMENT FILES Departm nt Use Only Unit Unit 4 Unit 5 UNDERGROUND TANK (UST) CLEANUP SrrE (LOP) q HOUSING ABATEMENT �T SOLJD WASTE F OTHER CLEANUP SITE (NON -LOP) b FOOD FACILITY ,jtf{ SOLID WASTE �j ' r UNDERGROUND TANK (MONITORINWREMOVAL) L7 POG KENNEL DAIRY HAZARDOUS WASTE GENERATOR 4� CHICKEN RANCH b FKG TREATMENT PLANT TIERED PERMITTED FAca-nry Q MOTEL/HOTEL b PUMPER TRUCKIYARDICHEM TOILI^TS � i L TATTOOISODY PIERCING 13 POOLISPA � LAND USE APPLICATION S(1E5 19 MEDICAL WAM FACILITY 13 MER (PLEL9E SPECIFY �� i 1. List up to ten addresses in the space above_ Select the type(s) of files from the list above �y checldnt the appropriate bores)_ At least one file type MUST be selected. Fax to (209) 46"138 or mail to the L p address Indicated above. 2. FHD will notify the applicant if any EHb files exist An appointment for review will be confirmed approximately five buslne_-s 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 tie scheduled accordingly. 3. A file that Is 2ct7vely being woi ked on by EHD staff may not be immediately available for review. A nen application may be submitted when the file Is available. 4. Any file not returned in the same condition as released will be reorganized by EH0 staff at the expens Of the applicant. Future file reviews by the sam0 applicant may require a $93.00 deposit prior to raviei 6- *TFNTATIVE appointment dates must be confirmed with EHD staff. 6. Applications received after 3:00 om will be processed the next business day. CONFIRMED APPOIWME;NT DAPI~ TIME -- DATE C014FIRMED �— _ 'PHONE . FAX INITIAL5'-. REVIEWED YES NO REVIEW DATE TOTAL P.O: FILE. ADDRESS rp) nn Rn rr 3GdA Aipno ---r W PLt c4 NJ Z Scrst 9. .1 b rl r n 5- 3hret cd ON 6 sirteq PEn>:T62. ejQVAb a 7. steel QN UTA NJ 1 R?d� r000 ' r e. a. 10 bvrm Sb -&81 1#N CIRC- FALLRDl 1� ON _3 r, r7 LLy L C—q) Sr ENVIRONMENTAL HEALTH DEPAI' TMENT FILES Departm nt Use Only Unit Unit 4 Unit 5 UNDERGROUND TANK (UST) CLEANUP SrrE (LOP) q HOUSING ABATEMENT �T SOLJD WASTE F OTHER CLEANUP SITE (NON -LOP) b FOOD FACILITY ,jtf{ SOLID WASTE �j ' r UNDERGROUND TANK (MONITORINWREMOVAL) L7 POG KENNEL DAIRY HAZARDOUS WASTE GENERATOR 4� CHICKEN RANCH b FKG TREATMENT PLANT TIERED PERMITTED FAca-nry Q MOTEL/HOTEL b PUMPER TRUCKIYARDICHEM TOILI^TS � i L TATTOOISODY PIERCING 13 POOLISPA � LAND USE APPLICATION S(1E5 19 MEDICAL WAM FACILITY 13 MER (PLEL9E SPECIFY �� i 1. List up to ten addresses in the space above_ Select the type(s) of files from the list above �y checldnt the appropriate bores)_ At least one file type MUST be selected. Fax to (209) 46"138 or mail to the L p address Indicated above. 2. FHD will notify the applicant if any EHb files exist An appointment for review will be confirmed approximately five buslne_-s 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 tie scheduled accordingly. 3. A file that Is 2ct7vely being woi ked on by EHD staff may not be immediately available for review. A nen application may be submitted when the file Is available. 4. Any file not returned in the same condition as released will be reorganized by EH0 staff at the expens Of the applicant. Future file reviews by the sam0 applicant may require a $93.00 deposit prior to raviei 6- *TFNTATIVE appointment dates must be confirmed with EHD staff. 6. Applications received after 3:00 om will be processed the next business day. CONFIRMED APPOIWME;NT DAPI~ TIME -- DATE C014FIRMED �— _ 'PHONE . FAX INITIAL5'-. REVIEWED YES NO REVIEW DATE TOTAL P.O: