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�ulv-ir-�b1�5 16�19 CONDOR EARTH TECH <br /> 209 532 0773 P.02 <br /> 1� 0"JVAYL)M, %.VUlvl x <br /> Ffv�IRONMENTAL HEALTil DF-VARA.AT <br /> 304 E Weber Ave P Floor Stockton, CA.95205 <br /> �,V N 9, U 1 OW9)468-3420 Fax: (209)464-0138 Web:www.c0-San-joaquin.ca.us/ehd YZO 04VIRONMENT HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: IIUSINESS/AGENCY:_ �1 hr5 j� ( ArL�ra �Ct� 1.I,, <br /> ADDRESS; 1 6&:s FTN LANG <br /> PHONE:_ X3 a • DFACSIMILE;_ <br /> TENTATIVE*APPOINTMENT DATE: "1 QQ Time: f 1I <br /> (Please allow 10 buslmeas days from A of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-$93.00 FEE—REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> / Department Use Only <br /> FILE ADORE$$ UNIT <br /> ,. so-eet14211 p <br /> z. s,,,e, 3 p Q Unit 1 <br /> 3. 6,W10 a Unit 2 <br /> 4, sine City <br /> �l <br /> s. u s t-i a.l ve• a Unit 3 <br /> 6. sv 2-9 S. u G <br /> 7. aft" S-1 a Unit 4 <br /> a, wool '7l 0 S l e- <br /> 9. &. ❑ Unit 5 <br /> ,o- sveei9�4 5. o�FCfiO n , <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES 6"; <br /> Trip <br /> UNDERGROUND TANK(UST)CLEANUP SFM(LOP) 11 HOUSING ABATEMENT SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-.OP) ❑ FOOD FACILITY SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONrrOR1NG/REMOVAL) ❑ DOG KENNEL 9d DAIRY <br /> HAZARDOUS WASTE GENERATOR C1 CHICKEN RANCH 13 PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY 13 MCgtLJHOTEL 0 PUMPER TRUCKIYARD/CHFM TOILETS <br /> 11TATTOMoDY PIERCING 173POOLISPA }1C-LAND USE APPLICATION SITES <br /> J81`-MEDICAL WASTE FACILITY Q OTHER(PLEASE SPECIFY) <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 /> address Indicated above. <br /> 2. EHD will notify the applicant if any EHO 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$93.00 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 /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE= . FAX ' INITIALS' <br /> REVIEWED YES NO REVIEW DATE <br /> EHD 48.02-066 _ <br /> 9/6�20tlI - . <br /> TOTAL P.02 <br />