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08/29/2005 08:32 FAX 12093881778 CONDOR EARTH TECH 16002/002 <br /> DOR EARTH <br /> aRTH TECH 209 532 0773 P103 <br /> V IUUll1 VAa�Vil\ 4�+�a as �Q <br /> ENVIRowyuNTAL HF.ALTE DEPARTMENT T <br /> /_+I I r, 2 9 2005 304 E Weber Ave P Floor Stockton, CA 95205 I <br /> (209)458-3420 Fax: (209)464-0139 Web:www.co.san-joaquirLca.U5/and <br /> ENVIRONMENT HEALTH " <br /> PERMIT/SERVICES �JPUBLIC RECORDS RELEASE APPLTCAIJON <br /> APPLICANT: �.C: / / �l'� eUSINEeS/AGiNCY• Cm��r L^cG r'+ r/ !c._.y ale/a iU <br /> ADDRESa: /73 -7 <br /> PHONE: C�o9J 3 a S— �J6 a/ FACSIMILE: <br /> TENTATIVI!*APPOINrMffNYUATF.; <br /> i (Please Know 10 bualness d"a from dote of appllcatlon cubmtKIM <br /> CHECK OOXTOEXPEDITS QUEST- �FEE "QUFATPROCESSED IN9NUSINESSDAYS p <br /> SIGNATURE OF APPLICANT ��7 zi7 �c-- DATE <br /> DepartmOnt LJae Only <br /> FLLEADDREGS UNI <br /> MVV I1,S"r v a... yl S. �' fv�a�' o1vac T 0 Unit 1 <br /> ° M Unit 2 <br /> 4 <br /> Unit 3 <br /> e am r-'�Q <br /> T. ly <br /> �Unit 4 <br /> n' Unll 5 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDEROROUNDYANK(UST)CLEANUP aTTE(LOP) 0 HOUSING ABATEMENT to SOLIDWASTsr-ACILrrY <br /> ❑ OTHER CLEANUP SrTE(RON•LOP) 0 FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> X UNDERGROUND TANK(MONRORINGIREMOVAL) ❑ DOG KENNEL L7 DAIRY <br /> G HAZARDOUS WASTE OENIRATOR G CHK71EN RANCH V PKO TREATMENT PLANT <br /> O TIERED PERMITTED FACILITY o MOTELMOTEL ❑ PUMPER TRUCKIYARDICHEM TOIL <br /> CI TATTOOIBODY PIERCING POOLISPA C3 LAND USE APPLICATION STIES <br /> {0 MEDICAL WASTE FACLLTTY P OTHER(PLEASE SPECIFY) <br /> 1. List up to ten addroases In the space above. Select the type(s)of fifes from the list abgya by ahwid r <br /> the appropriate box(es). At least one file type MUST be selected. Fax to f209)49"13a ar mail to t � <br /> address Lldicated eboxe, <br /> 2, EHD will notify the applicant K any EHD tiles 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 flies <br /> will be hold 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 EHD staff may not be Immediately avallagle for review. A new <br /> application may be submitted when the file Is av■ilablo. <br /> A. Any tTla 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 some applicant may require a$93,00 deposit prior to review. <br /> S. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> .-d-0 1F1RNl,�,i9►'P I . Ei7TDATE . rl+~i <br /> `i <br /> Iiiled ''P►{0 <. hj' W 5 ^A,i;r>'i;•;,:, <br /> CON� NE ffA)C"..;r, w,a;•„ �� ' <br /> R$VjEymt) VES NO REVIEW DgT� j t,. <br /> ' wneas , <br /> TOTAL P.03 <br />