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GEOLOGICAL TECHNICS HAUL Uli-y <br /> 08/28/2002 14:57 2095224227 TO <br /> SAa V 73 <br /> �AQUIN COUNTYPU�LIC HEALTH �r1VICE5 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR Ron <br /> r(`���f(ll`IJJ r�) <br /> I STOCKTON CA 95202 u u E;�E� 1 \1 ��I.l^- <br /> (209)468-420 <br /> \ <br /> OUBIC RECORDS RELEASE APPLICATION AUG 2 9 2002 <br /> APPLICANTSINEMAGENCY `C S.. myiRnNMM H A T' <br /> . ADDRESS \�� \ � �. � � 'h-"o ' s A- Qt, cjS 3 eRMIT/SERVICES <br /> PHONE 57'x'" �—�t� FACSIMILE <br /> TENTATIVE'APPOINTMENT DATE A—(k- v n TIME��� <br /> (Please ve T to 70�nx fivm,dale of a Il�tion 6tdlmitlaq <br /> CHECK sox TO EXPXDITE n!tQU T-$37.lFEE—RE1�Q 'T PROCEED I 3 BUSINESS DAYS <br /> SIGNATURE OF,APPLICANT \`I�XJ DATE <br /> i <br /> FILE ADDRESS THIS EIDE EHD STAFF USE ONLY <br /> I PROGRAM ELCMENT9 SEARCH <br /> � D <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDE"ROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT Q SOLID WASTE FACILITY <br /> 4 OTHER CLEANUP SITE(NON-1-011) ❑ FOOD FACILITY ❑ SOLID WASTE VENICE@ <br /> W UNDERGROUND TANK(MONITRINGIREMOVAL) CIDOG KENNEL ❑ DAIRY <br /> III HAZARDOUS WASTE GFNERAttOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> O TIERED PERMITTED FACILITY j G MOTLUHOTEL ❑ PUMPER TRUCKIYARINCHEM TOILETS <br /> ❑ TATTOCIBODY PEIRCING ❑ POOLISPA O LAND USE APPLICATION ScrES <br /> ❑ MHbICAL WAST[FACILUY i ❑ PUBLIC 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 /> "a "" <br /> boic(es). At least one file type MUST be selected. Fax to(209) 464.0138 or mall to the <br /> address'rate"bove. <br /> 2. EMU will notify the!applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately fivelbusiness 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 b submitted when the file is available. <br /> 4. Any file not returnd In the same condition as released will be reorganized by EMD staff at the expense <br /> of the applicant Fture file reviews by the same applicant may require a$87.00 deposit prior to review. <br /> S. 'TENTATIVE appolhtment dates must be confirmed with EHO staff. <br /> 6. Applications receded 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 /> en oa � w!p <br /> TOTAL P.01 <br />