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Aug • 12 . 2002 12 :01PM <br /> rnNDOR EARTH TECHNOLOGIES NO .0818 P • •1/ 1 <br /> paTfi RECF1VEfl <br /> SAN ,lOAQUlN COUNTYPUBLIC HEALTH SERVI zrcE� — i /J <br /> ENVIRONMENTAL HEALTH DIVISION "� lU <br /> 304 EAST WEBER AVENUE,THIRD FLOOR AUG 12 2002 <br /> STOCKTON CA 95202 <br /> (209) 40-3420NVIR01V1V9ENT HEALTH <br /> PUBLIC RECORDS ( LEASE APPLICATION <br /> --- <br /> APPLICANT <br /> �a, �^�,,,SU51NES5lAG1=idCY �— <br /> PHONE <br /> h 2 L-� �I�-, FACS(BUL>= ���'' <br /> TeJTATIVE"APPOINTMENT DATE 716 <br /> (Please give 7 to 10 husines5 d to of fi�On submdtan <br /> CK BOX TO EXPEDITE REQUE57- 0 <br /> WPR ED 1 S BUSINESS DAYS <br /> Ct1>~ <br /> DATEr7` L <br /> SIGNATURE OF APPLICANT <br /> FILE ADDRESSTHtS 514E EHO STAFF USE ONLY <br /> PROGRA I ELEWENn SEARCH <br /> 10 12 <br /> St. . <br /> /J`I c,o'1-1` <br /> 8 alo 5 <br /> ENVIRONMENTAL HEALTH DIVISION F'LES <br /> ❑ HOUSING ABATEMENT l§ SOLID WASTE FACILITY <br /> iX UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ FOOD FACa1TY j9' SOLID WASM VEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) C] DOG KENNi M DAIRY <br /> �t UNDERGROUND TANK IMONIXOWNGIREMOVAW ❑ CHICKEN <br /> N BCH 0 PKG TREATMENT PLANTQ( HAZARDOUS WASTE GENERATOR ❑ M R N 0 PUMPER'1RUCKIYARVICHENITO1LM <br /> 9r TIERED PER51rr1'ED FACILITY ❑ POOL/9PA C) LAND USE APPLICATION SITES <br /> D TATTOMODY FORCING D pU19UC WATER SYSTEM ❑ OTHER(PLEASE$PECW Y ABOVE) <br /> MEDICAL WASTE FACILITY <br /> 1, e(s) of files from list up to ten addresses in the space above. Select the typthe list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fto 209 454-01 8 or mai{to e <br /> EM <br /> address indicated above. y for review will be confirmed <br /> 2. EHD will notify the applicant if an EHD Ellet exist te appointment yslication. The files <br /> approximately five business days but in later than ten 10 da afterreceipt hould be scheduled <br /> will be held for a maximum of five business days for review. Appo <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available tot review. Anew <br /> application may be submitted when the file is available. ��� by EHD staff at the expense <br /> 4. Any file not returned in the same condition as refessed will be reorganized <br /> a $87.00 deposit prior to review. <br /> of the applicant Future file reviews by the same applicant may req <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 /> CONFIRMED APPOINTMENT DATE TIME <br /> .......... .. <br /> f1�TF�`f1AICID�eFn • <br />