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Nov . 12 . 2002 4:06PM CONI "R EARTH TECHNOLOGIES Ho. 1895 P . 1/1 <br /> OATS REGEfVEA EHD LOG NUMBER <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION I ���a[���'' r�) <br /> 304 FAST WEBER AVENUE,THiRD FLOOR ,_.. <br /> 10 STOCK-TON CA 95202 <br /> (209)"B-3420NO V 1 2 2002 <br /> PUBLIC RECORDS RELEASE APPLICATION\LOrgl( <br /> a�ERViCESAPPUGANTMLtftt-- ►nOIVelrC BUSiNESS/AGENCYCNOef, <br /> ADDRESS r`klJK- W ESrt"6 -CLC <br /> PHONE 16-9— <br /> FACSIMILE �01- —t5'W <br /> I11 Ll= Tl� <br /> TENTATIVE'APPOINTMENT DATE TiME <br /> �' (QIe+S -gll <br /> ve 7kF: <br /> 3REIT <br /> days m to of appllcaUon submtttd�Q <br /> CHECK 13OX TO EXPED E REQlE .0PROC SS ED IN 3 BUSINESS DAWIRUNMENT HLALTH <br /> SIGNATURE OF APPLICAN f PDAT�T/SF�RVI zS v� <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> 300 CAS( Fo <br /> t_ Fo <br /> W Fo i <br /> S• L- Ict� <br /> tA, <br /> ze 1-fM N I�i <br /> q4(4 - fi*-z6 L- E_ <br /> n 5. '5A N --So <br /> ;171T 5. SU ST: <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> ,Pf UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING AHATMENT SOLID WASTE FACILITY <br /> X OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY C1SOLID WASTE VEHICLE <br /> .Zr UNDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> X HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑ MOTEL/HOTEL O PUMPER TRUCK/YARDICHEM TOILETS <br /> ❑ TATTOO/SODY PEiRCING ❑ POOLJSPA ❑ LAND USE APPUCATION SITES <br /> ❑ MEDICAL.WASTE FACILITY ❑ PUSUC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-0138 or mail to the <br /> addressindicated above. <br /> 2. EHD will notify the applicant 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 actively being worked on by EHD staff may not be immediately available for review. A new <br /> application may be submitted when the file is 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 Future file reviews by the same applicant may require a $87.00 deposit prior to review. <br /> 5. '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 /> VONFIRMED APPOINTMENT QATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br />