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n <br /> Jul . 2 5' PM CANDOR EARTH TECHNOLOGIES No • 0304 P • • 1/1 <br /> -A Tr';. <br /> ASC <br /> SAN'JOAQUIN COUNTYPUBLIC HEALTH SERVICES EMD LGGNUMBER <br /> ENVIRONMENTAL. HEALTH DIVISION �r <br /> 304 EAST WEBER AVENUE, THIRD FLOOR <br /> STOCKTON CA 95202 <br /> XJl_ I PUBLIC RECO (209)468-3420 <br /> APPLICA <br /> v DS RELEASE APPL►CAON <br /> USINESS/ACLNCY Conotor <br /> �� �.ot <br /> n t a.s T Wj c. <br /> ADDRESS <br /> �ra►1k �ir•ct¢ �u � � T +o�(�{� [.A 9S-2-0 (. <br /> PHONE FACSIMILE 2 a"f 2 3 4 — O 5 <br /> TENTATIVE*APl OINTMENT DATE ---YL b Z— nME � <br /> (PIBAse give 7 t4 10 b sine d t appli on 7—a. <br /> VEt I 'CHECK BOX TO EAPEDITEIRE=QUEST-$87.00REQ EST PROC <br /> E >;A IN 3 B SINE55 DAYS <br /> SIGNATURE pF APPLICANT DATE °I O z- <br /> F( E ADDRESS THIS SIDE EMD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> \V 16e2 <br /> N, Mev, c;►tic �-. (it/. <br /> -383c) <br /> w O <br /> ZGS I W. A • N <br /> t 20I'LL,1'e. 2)UU LUL ILU�ff <br /> VV Z(A <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)C EANUP SITE(LOP) ❑ HOUSING ABATEMENT 1:3LI <br /> SOD WASTE FACILITY <br /> UNDERGROUND <br /> CLEANUP SITE(NON-L P) ❑ FOOD FAC1LfrY ❑ SOLID WASTE VEHICU <br /> �T=FRED <br /> ' NDERGROUND TANK(MONrr RING/REMOVAL) ❑ DOG KENNEL 0 DAIRY <br /> DOUS WASTE GENERAOR ❑ CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> PERMITTED FACILITY Cl MOTEL/HOTEL ❑ PUMPER TRUCK/YARD/CHEM TOILETS <br /> 17 TATTOO/BODY PEIRCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM CI OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses in the Space above. Select the type(S) of riles from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-0130 or mail to the <br /> addrQsa indicated above. <br /> 2. EHD will notify the ppllcant if any EHD files exist, An appointment for review will be confirmed <br /> approximately five Business days 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 active) being worked on by EHD staff may not be Immediately available for review. A new <br /> application may be ubmitted when the file I5 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. Fu ure file reviews by the same applicant may require a $87.00 deposit prior to revlew. <br /> 5. *TENTATIVE appoin ment dates must be confirmed with EHD staff. <br /> 6. Applications receiv d after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE <br /> TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br />