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09/10/2002 15:37 <br />b'f-1'(- JYJh'I•I <br />A a 3E' <br />V <br />9252836121 <br />rKUI'I <br />AEI CONSULTANTS (SF) <br />IU <br />PAGE 01 <br />1j GtLi67.11�1 t .IUl <br />U tifl <br />t <br />SAN JOAQUkN COUNTYPU13LIC HFALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />i '304 EAST WEBER AVENUE, TIitRD FLOOR <br />' STOCKTCNi CA $5202, <br />Pd )) 488 420 <br />PU$LIO RE, CORDS RELEASE APPLICATION <br />1APP CIT'- SUSINE5StAOENC Coo 5 V � � � I !'L C <br />lylVl E�ivlC S <br />;; U ' S H <br />,__ 7�S Z�33 , 6 Cx1 U x u a 1 1 v, <br />PHONE <br />C�FAfCSEMGILE � Z�. Z 8 �i 2 <br />TENTATIVE* APPomTMENT'DATE TIME <br />(Plewa VV9 7 to'lus- ess d dat0-;S <br />icatio subfttAal) <br />17 <br />ECKBOX 70 EXPESITE REQUES�' •$87,C e. <br />04 TP ESSUST SS DAYS <br />-SIGNATURE OF APPLICANT DATE. l� <br />ENViRONMENTAL HEALTH DIVISION FILES <br />UNOERGROUND TANK (UST) CLEANU� SITE (LOP) O HOUSING AAATEMEN7 ❑ SOLID WASTE FACUJTY <br />OTMER GLEANU° SITE (NON -LOP) ' ' ❑ FOOO FACILITY 0 SOLID WASTE VEHICLE <br />NZaRGROUND TANK (MONITORINGtkEMOVAL) 0 DOG KENNEL O DAIRY <br />AZAPOQUS WASTE GENERAY01Z I ❑ CHICKEN R4HGH n PKG TREAtMPN7PLANT <br />TIERED PERM1TTEo PAGILITY ❑ MQT! l /HOTEL M PUMPER TRUCiUYARWCHEM TOILETS <br />❑', TATTOQIGQOY PEERCMG t7 pflOIJSPA ID LAND USE APPLICATION SITES <br />M MFDIGAt.wASTE FACI1.tYY ❑ PUBLIc WATERSYSTEEM 0 OTHER (PLEASL SPECIFYAaCVEi <br />t, List up to tpn addresses;irl the space above. Select the types) of files from thu list above by checking <br />the appropriate box(as)_; At least Ono File type MUST be seiected. Fax to (209) 464-0138 or mai to tho <br />address indicated ab4vt_ <br />2, F.HO will notlf� the appll�arit If any EHD files exist. An appointment for roview will be confirmed <br />approximately fiva busirhess 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 />accordlagiy. <br />3. A file that is actively being-worKed on by EHD staff may not bo immediately available forre�lew. A new <br />appligation may bo ssubr':Ated when tho file is availabl6. <br />4. Any filo not roturned in a samo condition as rolcascd will be reorganized by EHD staff at the expense <br />of the applicant. Future flle reviews by the same applicant may require a $37.00 doposit prior to review. <br />5. TENTATIVE appointmerilt dates must be conflrmed with EHD staff. <br />6. Applic4ort5 received after 3:00 pm will be processed the next busine" day. <br />tDNFIRMED AF�pQINTMF_NT BATF- TIME <br />ATE -CONFIRMED PHONE FAX IXITIALS <br />gEYICWED YES NO REVIEW DATE <br />i. <br />00 14.. •04471go TOTAL. P-01 <br />