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'I <br /> Apr . 9 . 2003 3 : 22PM CONDOR EARTH TECHNOLOGIES No • 3359 P I / I <br /> %W LOG NOMER <br /> DATE NECEVED <br /> _ , 2SAN JOAQU1N COUNTYPUBLIC HEALTH SLi % VICES <br /> ENVIRONMENTAL. HEALTH DIVISION <br /> 304 EAST WE AVENUE, THIRD FLOOR I <br /> I APR 0 9 2003 <br /> STOCK <br /> TON CA 95202 <br /> (209) 46$�420 35 <br /> ENVIii ( )NMENT HEA 'RI�J LIC RECORDS RELEASE APPUG)VION <br /> r{ VI CON 6-v -- <br /> APPLICANT I ' IG6FI/ I " `-1`IV C`I�� BUSiNESSIAGENCY <br /> ADDRESS �1 FrtN�t� West- C,� ot"I Swtr� 1. �c,;!e r NI Gq <br /> PHONE Zdl , Z3 0 ,31 $ - FACSIMILE 2,01 Z 3 q . 0 5 3 8 _ -- <br /> TENTATIVE' APPt7¢rrMENTOATE ( �/ o TIME <br /> II <br /> (Phase give 7 to 10f business days from date of appecatlon submitlai) <br /> . CHECK BOX TO EXPEDITE REQUEST - S .De FEE — REQUEST PROCESSED IN 3 BUSINESS GAY 4^"S LA , • + �I �I <br /> SIGNATURE OF APPLICA _ DATE `I O 3 <br /> FILE ADDRESS THIS SWE L:HD STAI�I� USE ONLY <br /> PROGRAMA E1J-NIENT$ SEARCH <br /> 3G =iZ <br /> S . OL Po Q I 75 tri <br /> 3 o S. +vim d J <br /> 3 z 4 <br /> z 8 N 2 �TKE� 5 a <br /> U - <br /> z tsm S . Rnv7 <br /> LII am <br /> ,..,.. <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> ,uNveaswUND TANK (UST) CLEANUP SITE (LOP) ra HOUSING ABATEMENT /r.� SOIJO WAST✓; ',413LIrY <br /> y <br /> F OTHER CLEANUP SI'rr= (NON�LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> Iffi1, UNDERGROUND TANK (MONRORING/REMOVAL) ❑ 006 KENNEL 0 DAIRY' - <br /> §a. HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PK(; TI%j i RATR KENT PLANT <br /> P TIERED PERMITTED FACILITY ❑ MOTE)JHOTEL % ❑ PUOIpI EUCIG�YARDlCNEM TOILE"r43 <br /> ❑ TATTOO( BODY PEIRCING 13POOLI .- 1 ❑ L4&10 USE APPLICATION SUES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM 0 OTtuin, (PLEASE SPECIFY ABOVE) <br /> j 1 . List up to ten addresses in the space above, Select the type(s) of files frons the 11 t above by checking <br /> the appropriate box(es). At least one file type MUST be selected, Fax y� <br /> t 09) 464_0_038 or mail to the <br /> address indicated above, <br /> 2. EHD will notify the applicant if any END files exist. An appointment for review will bel confirmed <br /> approximately five business days but no later than ten (10) days after receipt of apPl€cation, The files <br /> will be held for a maximum of five business days for review. Appointmenbi, should be scheduled <br /> accordingly. <br /> 3, A file that is actively being worked on by EHD staff may not be immediataly available for review. A 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 587.00 deposit prior to reVICW. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff, <br /> 64 Applications received after 3:00 pm Will be processed the next business day. <br /> t;0NFI Rmr=D APPOINTMENT DATE <br /> TIME T -- --- <br /> DATE CONFIRMED PHONE FAX INITIALS <br />