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SeP . 4. 2003 12:43PM CON,6 EARTH TECHNOLOGIES No • 4879 P. I/I <br /> DA1 t mm� vtu <br /> SAN JOAQUIN COUNTY tnu LUG NUN• <br /> l,Ill_„ ENVIRONMNTAL MALTif D"APTmzNT <br /> 304 E Weber Ave 3N Floor Stockton, CA 95205 SEP` 0 4 2QOV9)468-3420 Fax: (209)464-0138 Web: www.cO-Saujoaquiu.caus/ehdI q10 <br /> fvvl iu(lfJENT HE/�LTN p/UgLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Fi_TS (6)ZA I EL BUSINESS/AGE�Ncy: <br /> ADDRESS: �� G(.� JT_ <br /> �! l . 'S—F ,TO <br /> rPHONL_ 2 <br /> All....,e z,^••`- , <br /> TENTATIVE*APPOINTMENT DATE. 1 S ♦ )Y� �• 03 Time: <br /> (Please allow 10 business days from date of application submittal) <br /> CHECK BOX TO EXPEDITE REQUE5•L.SVB�J...00 FEE—REQUESTPROCESSED IN 7 BUSINESS DAYS ,Q,, <br /> SIGNATURE OF APPLICANT C` 1 DATE 54 le D3 <br /> Department Use Orgy <br /> FILE ADDRESS - V L UNIT <br /> W• qrrA, dZt ._O c�tov� <br /> ❑ Unit 1 <br /> 6 15 <br /> S t a <br /> o q (�✓ <br /> 4. so- �.. -Z5,• Narrs <br /> ,,son . ,� Unit2 <br /> s. saeel ) , O l�—t c C tf J Unit <br /> I <br /> z ( t• <br /> e. so-ee, 03 tvt l { Unit4 <br /> 9. so-.. , <br /> to. So- fir J ElUnit 5 <br /> ENVIR &MENTAL HEALTH DEPARTMENT FILES <br /> rr5!l'r�,� UNDERGROUND TANK(UST)CLEANUP SITE(LOP) CIHOUSING ABATEMENT SOLID WASTE FACILITY <br /> �y OTHER CLEANUP SITE(NON-LOP) " ❑ FOOD FACILITY SOLID WASTE VEHICLE <br /> ❑ UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ld PUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑ TATTOOIBODY PIERCING ❑ POOLISPA Imo'LAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the Iist above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax.tg (209)464-0138 or mail to the <br /> address indicated 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 flies <br /> will be held for a maximum of five business days for review. Appointments should tie scheduled <br /> accordingly, <br /> 3. A file that is actively being worked on by EHD staff may not be Immediately available for review. A ne, <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 expens <br /> of the applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to revim <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 /> �,o aeazaas <br />