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DEC -13-2004 12:53 <br />PATE RECEIVED ._ _ <br />DEC i ;3 2004 <br />(209) 40 <br />i,AU; L: <br />PERM,'': s `i'i' FS <br />CONDOR EARTH TECH 209 532 0773 P.01i0: <br />� <br />A.N JOAQUIN COUNTY E}ip LOG NGN <br />ErrvmomzNTA.L R ALiw DEPARImENT <br />304 E Weber Ave 3`d Floor Stooltoi,, CA 95205 <br />420 Fax: (209) 464-0138 Web: wWW-co,San joat)uhLcaus/ehd <br />'CSLIC RECORDS RELEASE AY PLICATION <br />APPLC <br />IANT: 1 �t A`" I� BUS(NESSIAGENCY: �>0R &A PTP <br />' Kms-f7/WLR <br />A13DRESS: <br />PHONE( � — FACSIMILE: — c1 � F <br />TENTAT. ^^�� ' <br />ll� Ar'POWTMENT DATE. � � _L.J�C-�►y� �{.'lee: '&.A"x ;E': <br />(Please allow 10 buslnaas days from date of appl!cation submlttan <br />�+ CHECK BOX TO DC!'EDITE RJ Q= T - $33.00 FFE -- REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT DATE 1�- 07044 <br />Department Use Only <br />FILE ADDRESS <br />s�..+3r,,2 4U L UUUnit 1 <br />2- s� <br />s"w •4 3 <br />s� vtyr' Unit 2 <br />s s e Unit V <br />�- s� PENT�2 b a� <br />7. t-op�jtl <br />L TAhl IIZF'DI� r 0� 4 -� Unit 4 ") <br />a- tJ o rm fc fU►Z 'j.—� G%1 5 T' rrne� (ON RAtLRt�A1a """"c 1633 L Cj;i Sr Units <br />� o. :;vee1 C1ty l <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />UNDERGROUND TANK (UST) C LEANUP srrE (LOP) 4 HOUSING ABATEMENT SOLID WASTE <br />OTHER CLEANUP SITE (NON OP) b FOOD FAmLnY k8OUDWASTrVE-..-_, r: <br />UNDERGROUND TANK (MO ORWGwEmovAL) DOG KENNEL jtf DAIRY <br />HAZARDOUS WASTE SEUMNOR & CHICKEN RANCH 0 PKG TREATMENT PLANT <br />TIERED PERMrrrED FAjmLrry O MOTELMOTEL ❑ PUMPER TRUCKIYARDICHEM TOILM <br />CI <br />TATTOO/2013Y PIFJICING D POOLISPA )2! LAND USE APPLICATION SRES <br />1@ MEDICAL WASTE FACUM ❑ OTHER (PLEASE SPECiFYj <br />1. List up to ten add sses in the spade above_ Select the type(s) of files from the list above py checidnt ' <br />the appropriate b x(es)_ At least one file type MUST be selected. Fax to (209) 464--`138 or mail to the <br />address Indicatee above. <br />2. FHD will notify th appli=nt if any E147 files exist An appointment for review will be a. anfirmed <br />approximately fiv business days but no later than ten (10) days after receipt of application_ The files <br />will be held for a aximum of five business days for review. Appointments should be scheduled <br />accordingly. - <br />3. A file that Is act7v ly being worked on by EHD staff' may not be immediately available for review. A no, <br />application may be submitted when the file Is available. <br />4. Any file not retu ed in the same condition as released will be reorganized by EHD staff at the expens <br />of the applicant uture file reviews by the same applicant may require a $93.00 dep(,zit prior to ravie) <br />*TFNTAT'NE appointment dates must be confirmed with EHD Staff. t <br />6. Applicatlons retia ved after 3:00 pm will be processed the next business day. <br />C-ONFIRME <br />D APPdINTM _('JT' I�fiiE � TIME { s <br />DATE CONFIRMED PH0ME FAX INITIALS'-. <br />REVIEWED .- YES NO REVIEW DATE _ <br />TOTAL P.O: <br />