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Mar-iO- 2003 4:49PM CONVO EARTH TECHNOLOGIES <br />No -3039 P )/I <br />JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br />ENVIRONMENTAL. HEALTH DIVISION <br />MAR 1'o 2003 304 EAST WEBER AVENUE, THIRD FLOOR 1192 STOCKTON CA 9.5202 <br />t ci-WNMEN T HEALTH (209) 468.3420 <br />PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT �: GL�+7(�,�(�� \/, BUSIN <br />E <br />SS <br />/A <br />GENCY <br />ADDRESS ,����Y�e.,(M�`��rC� �A �.�i l�__��CJ <br />PHONE., -r ���� �� —FACSIMILE <br />TENTATIVE* APPOINTMENT DATE I9___M ag-ck D- TIME_�_f <br />(Please give 7 to 10 business days from date of application sub"V21) <br />M CHECK BOXTO EXPEDITE REQUEST -$87.00 FEE <br />SIGNATURE OF APPLICANT <br />I <br />+A <br />IN3BUSINESS DqYU 1 1 <br />,.�5P <br />DATE <br />i <br />0 16P ' 1 <br />WV <br />LU <br />1 <br />ENVIRONMENTAL. HEALTH DIVISION FILES <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) rl HOUSING ABATEMENT SOLID WASTE FACILITY <br />OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY 9 SOLID WASTE VEHICLE <br />UNDERGROUND TANK (MOND"ORING/REMOVAL) ❑ DOG KENNEL ❑ DAIRY <br />HAZARDOUS WASTE GENERATOR U CHICKEN RANCH ❑ PKG TREATWEtiTPLANT <br />p+ TIERED PERMI I -ED FACILITY ❑ MOTELMMEL ❑ PUMPr.R TRUCKIYARDICHEM TOILETS <br />❑ TATi00/BODYPEIRCING ❑ POOLISPA ❑ LAND USE APPLICATION SUMS <br />❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ o-rHEit (PLEASE::iPEC1rYA6OVE) <br />1. List up to ten addresses in the space above. Select the type(s) of files from the li:i t above by checking <br />the appropriate box(es). At least one file type MUST be selected. Fa to 209 40x 0138 or mail tothe <br />address Indicated above. <br />2. EHD will notify the applicant if any EHD files exist. An appointment for review will he confirmed <br />approximately five business days but no later than ten (10) days after receipt of application. The 5les <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 availablo 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 $37.00 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 />