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Mar • 10. 2003 4:49PM CONDOR EARTH TECHNOLOGIES _ No•; 039 P - 1/1 <br /> la-to <br /> C�I <br /> la-tol00 Numaim <br /> Ir�ll1�- lI_�_, AN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> MAR 1'0 2003 304 EAST WEBER AVENUF-THIRf3 FLOOR <br /> STOCKTON CA 95202 <br /> _I�vl„JNMEN I• HEALTH . (209)468-3420 ° <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT Q HU31NESSIAGENCY ']Gla- 61 I-els <br /> ADDRESS I Q� <br /> PHONE za FAC-31JAI EF <br /> TENTATIVE;APPOINTMENT DATE 4_ oTIME <br /> JPIO O give 7 to 10 business days from date of application subnil 2l) <br /> CHECK 13OX TO F-XPEDITE REQUEST-$87.00 FEE--REQUEST PROCESSt_A IN 313USINESS DAY . o <br /> o <br /> SIGNATURE OF APPLICANT DATE •_10 f7 <br /> FILE ADDRESS THIS SIDE EHD STA!VF U-SE ONLY <br /> PROGRAId ELEMI' T5 SEARCH <br /> , . � <br /> 00 i <br /> iV 0 - <br /> dt <br /> • t'fie <br /> t '1 loo <br /> , D S. , `:n <br /> ENVIRONMENTAL.HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT � SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACRX1Y SOUD WASTE V"ICLE <br /> UNDERGROUND TANK(MONrrORINGmEMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR O•CHICKEN RANCH ❑ PKG TREATI♦AENTPL.ANT <br /> TIERED PERMITTED FACILITY ❑ MOTELIHOTEL CI PU(HP><R TRUCKJYARDICHEM TOILETS <br /> 17 TATTOO1800Y PEIRCING t7 POOUSPA - - ❑ LAND USE APPLICATION SITES <br /> Q MEDICAL WASTE FACILITY CI PUBLIC WATER SYSTEM 0 0T?1EEt(PLf=A:,k.rFECI-Y AIS OVE) <br /> 7. List Up to ten addresses in the space above. Select the type(s) of files from the ii:s-t above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to 209 4(i4t_Ut3$ or mail Yo the <br /> address Indicated.above. <br /> 2. EHD will notify the applicant if any EHD files exist. An appointment for review will to confirmed <br /> approximately five business days but no tater than ten (10) days after receipt of application. The files <br /> will be held for a maximum of five business days for review. Appointments should tie scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be Immediately available for review. A neve <br /> application may be submitted when the file is available. <br /> 4. Any file not returned in the same condition a$released will be reorganized by EHE} staff at the expense <br /> of the applicant Future file reviews by the same applicant may require a$37,00 d•eposit 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 />