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ADr • 9. 2003 3:22PM CONDOR EARTH TECHNOLOGIES No-3359 P . ►/► <br /> END COG NUVSER <br /> DATE REG4VED SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> CI I I �D� 304 EAST ENVIRONWEBER AVENUEDIVISIONMENTAL HEALTH <br /> ,THIRDFLOOR <br /> APR 0 9 2003 STOCKTON CA 95202 <br /> (209)468-3420 IR3 <br /> I=NV1r ONS MENT HE "P BL.IC RECORDS RELEASE APPLIC)kTION <br /> rt- <br /> vi <br /> APPUCANT �"�n 1 I (Y C� 6USINESSIAGENCY CON�o� 7{ _j�- WCILD 66 1 _ <br /> ADDRESS 060 Fe.�t- W6sr` nEL4-6, ��tr� 3 Svl��c�•ro,,�, �q <br /> PHONE Z� 7 � $ FACSIMILE S' .5 q 5 3 g _- <br /> TENTATiVE-APpcwTMFNT DATE O -nME /b►0 4 /�7t/� ` _���_ <br /> (Please give 7 to 1 business days from date of appllcatlon subinitdal) h <br /> . CHECK BOX TO EXPEDITE RJ~QUEST-SN.00 FEE•-REQUEST PROCESSED IN 3 BUSINESS DAYS �• • �� <br /> SIGNATURE OF APPLIC — DATE <br /> FILE ADDRESS THIS SIDE f ID STAFF USF NLO Y <br /> PROGR W 11EMENTS SEARCH <br /> 3U3 z s• t7L po u IJ 5 <br /> 31c-- .S. EL O tI <br /> 3 - 2 ✓ <br /> - <br /> z�tz� 5. f Ay 7 `-�1 <br /> z or s. P6A. _ - <br /> 3�{ c <br /> 3143 'SrdrtF-P-A-- w A`/ <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) U HOUSING ABATEMENT *r-f-SOIJD WASTE:,WlLrty <br /> F OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY I7 501.10 WASTE YIEHIICLE <br /> 23,UNDERGROUND TANK(MONITOWNGIREMOVAL) 0 DOG KENNEL, 0 DAIRY <br /> HAZARDOUS WASTE GENERATOR O CHICKEN RANCH ❑ PKG TRFATMr-iVr PLANT <br /> �f TIERED PERMfTTEo FACILITY Q MOTIEUHOTEL b PUDtpI R TRUcivyA;wtC2i"TOILEI:i <br /> El TATTOO/BODY PEIRCING 0 P00U5PA 0 LAID 115E APPLICATION SITES <br /> O MEDIcAL WASTE FACILITY 0 PUBLIC WATER SYSTEM 0 OTNEFt(PLEAS:E SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above. Select the type(S) of files from the IL,,t above by checking <br /> the appropriate bOX(es). At least one file type MUST be selected. Fax to (7 9) 464_Z38 or mail to thn <br /> addrgss indicated abovq, <br /> 2. EHD will notifyr the applicant if any EHD files exist. An appointment for review will 13c confimind <br /> approximately five business days but no later than ten (10)days after receipt of application. The files <br /> will be held fora maximum of five business days for review. Appoinlinenbi;should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EI-1D staff may not be immedlataly available for revie'N. A new <br /> application may be submitted when the file Is available. <br /> 4. Any file not returned in the same condition:is released will be reorganized by EHE7 staff at the expemie <br /> of the applicant Future file reviews by the same applicant may require a $87.00 de!I)oslt prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EMD staff, <br /> 6. Applications recel+ed after 3-00 pm will be processed the next business day. <br />