Laserfiche WebLink
Aur. 9. 2003 3:22PM CONDOR EARTH TECHNOLOGIES Ni) .3359 P. I/I <br />DATE RECF.IVEA MLOG NUMIIEIZ <br />TH <br />�n}Lr����� ���(�� ENVIRONMEN AL HEALTH DIVISIONR��IC>VS <br />304 EAST WEBER AVENUE, THIRD FLOOR <br />APR 0 9 2003 STOCKTON CA 95202 <br />(209) 468,3420 IR35 <br />-M/lfi0NMENT HFAIFPBLIC RECORDS RELEASE APPLICAINON <br />APPUCANT 164N QIAb "Tl SUSINESS/AGENCY CCIN bvI" I' :j7f 1VdLa G�L�J �� <br />ADDRESS 186F, Fr4kNy- nozc ,6,, ,�u( t't T - <br />PHONE Z _J SJ $ FACS11411-. 2,Oq 213 `t • 0 5 3 <br />TENTATIVE' APPCWTMENT DATE (?j 03 TIME /� a o �}T�I _�17_ 0 <br />(Please give 7 to 1 d business days fr4—Mdate of mpplicat1cm subtgitla! <br />. <br />CHECK BOX 70 EXPEDITE REQUEST - $;N100 FEE —REQUEST PROCESSED IN 3 BUSINESS GAYS �• � • � �� �r <br />SIGNATURE OF APPL.ICA _ DATE O 3 <br />FILE ADDRESS <br />O FOOD FACILITY <br />THIS SIDE I ID STAI: IlSE ONLY <br />25. UNDCROROUND TANK (MON ITORjNG/REMOVAL) <br />❑ DOG KENNEL <br />PROGRW LLEMEm1Z SEARCH <br />3057L S • (}t_ L>Offt. <br />I <br />❑ PKG TREATNICRT PLANT <br />TIERED PE}tMnTEA FACILITY <br />❑ MOTIEL(HOTEL <br />❑ PUOIPI::It TRUCKITARD/CHEM TOILE -1 i <br />EI TATTOO/BODY PEIRCING <br />❑ POOUSPA -- . <br />❑ LADID USE APPLICAT10N Sr F3 <br />3 z LlL-Zmz <br />0 PUBLIC WATER SYSTEM <br />❑ OTHER (PLEASE SPECIFY ABOVE) <br />- - <br />Z t7 S <br />vi3ob 5. r-tiy v <br />tJ <br />7 <br />- ---- <br />_ <br />ky <br />6k <br />L I L�z 15M <br />3 ,t s . a <br />3q-57 <br />R$ <br />Ef�=- <br />ENVIRONMENTAL HEALTH DIVISION FILES <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) G HOUSING AIRATEMENT KSOIJI] WASTE Al:1UTY <br />P OTHER CLEANUP SITE (NON -LOP) <br />O FOOD FACILITY <br />CISOI_1D WASTE VEHICLE <br />25. UNDCROROUND TANK (MON ITORjNG/REMOVAL) <br />❑ DOG KENNEL <br />V DAIRY <br />HAZARDOUS WASTE GENERATOR <br />0 CHICKEN RANCH <br />❑ PKG TREATNICRT PLANT <br />TIERED PE}tMnTEA FACILITY <br />❑ MOTIEL(HOTEL <br />❑ PUOIPI::It TRUCKITARD/CHEM TOILE -1 i <br />EI TATTOO/BODY PEIRCING <br />❑ POOUSPA -- . <br />❑ LADID USE APPLICAT10N Sr F3 <br />❑ WDICAL WASTE FACILITY <br />0 PUBLIC WATER SYSTEM <br />❑ OTHER (PLEASE SPECIFY ABOVE) <br />1. List up to ten addresses in the space above. Select the type(s) of files from the ILil above by checking <br />the appropriate box(es). At least one file type MUST be selected. fAA t 2.09 464_0 438 or mail to the <br />address Indicated above, <br />2. EHD will notify the applicant if any EHD files exist. An appointment for review will Ill confirmed <br />approximately five business nays but no later 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 be scheduled <br />accordingly. <br />3. A file that is actively being worked on by EFID staff may not be immedlabaly available for review. A ni.w <br />application may be submitted when the file Is available. <br />4. Any file not returned in the same Condition as released will be reorganixt:d by EHI] staff at the expenije <br />of the applicant. Future file reviews by the Name applicant may require a $1,7.00 dcposit prior to review. <br />5. 'TENTATIVE appointment dates must be confirmed with FHD staff, <br />6. Applications received after 3.00 pm will be processed the next business day. <br />CONFIRMED APPOINTMENT DATE _ - - TIME <br />DATE CONFIRMED _ PHONE FAX INITIALS <br />