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08/29/2005 08:32 FAX 12093881778 CONDOR EARTH TECH 11002/002 <br /> r� 09 ZOR EARTH TECH 209 532 0773 P.03 <br /> ENvmoI=N7cAL HEALTH DuA mmNT <br /> A u r; 2 9 2005 304 E Weber Ave 34 Floor Stockton, CA 95205 <br /> (209)458-3420 Fax: (209)464-0138 Web:www.co.san-joaquirL,ca.xWehd <br /> ENVIRONMENT HEALTH <br /> PERMIT/SERVICES NIBLIC RECORDS RELEASE"PLICATION <br /> APPLICANT. /V�Yf 9USIN OVAC ENCY: <br /> ADDRESS. 177� 7 �J/�/� a�� `SrG'/� /' l -� 4 C./? <br /> PHONE: Caoq� a e— 9� / FACSIMILE- <br /> TENTATNE'APPOiNTNI"y nATe; Time: �pp� <br /> (P{Riaa allow 10 business days hvm date of aPP11=tl0n subenttto TO i,�— ?J 7�/C— <br /> © CHECK SOX TO EXPffDrMpZQVEST-p3.00 <br /> FF.E--REQUEST PROCESSED INS OUSINM DAYS <br /> SIGNATURE OF APPLiCAI _ ,/���i c - DATE '-�l�%/D,�— <br /> Deimrtrn4nt I1ee Only <br /> .' FM ADDRESS UNIT e <br /> '7'/ GElUnit 1 <br /> a ❑ Unit 2 <br /> 4. wAa <br /> I. r4m Unit 3 t <br /> r. svee� JeUnit 4 <br /> aly <br /> ❑ Unit 5 <br /> ENVIRONMENTAL_HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(Ut9'T)CLEANUP aTTB(LOP) 0 MOUSING ABATEMENT 0 SOLiD WASTE FACILHY <br /> 0 OTHER l.I.FANUP SITE(ION-L-OP) O FOOD FACILITY O SOLID WASTE VEHICLES <br /> UNDERGROUND TANK(MONITORINGIREMOVA1a ❑ DOCS KENNEL 0 DAiRY <br /> Q HAZARDOUS WASTE 61NINATOR 10 CHMIEN RANCH 0 PCG TARATNi EW PLANT <br /> 0 TIRED PERMITTED FACILITY M MO7MLR*TgL 17 PUMPER TTRUCIVYARD/CHEm TOILETS <br /> E3 TATTOCISODY PIERCING o POOLAPA 0 LAND USE APPLICATLON SITEa <br /> G MEDICAL.WASTE FACTLTT Y LO OTHER(PLEASE SPECIFY) <br /> 1. List up to ten eddrossss in the apace vbovr, Select the type(s)of files from the list abcws by ohealdrig <br /> the appropl'late box(es). At least one file type MUST be selected. Fax to 209 49"139 or Mai t thl <br /> address_gdivate bone. <br /> 2. EHD will notify the applicant K any EHD files exist. An appointment for review rn"il be confirmed <br /> approximately five business days but no later than ton(1Q)days after receipt of application. The flies <br /> will be held for a maximum of five buslness days for review. Appointments should be seWuled <br /> accordingly. <br /> 3. Aflle that Is actively being worked on by EHD staff may not be Immediately avaalltLble for wvlow. Anew <br /> application may be submitted when the file Is available. <br /> 4, Any Ilia not returned In the same condition as released will ba 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 /> s. *TF-NTATrvE apFalntmont detos must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm wnl be processed the ynext b�uslneea day. <br /> tii?NF1RM J? APp,b,l ENT DA `'f !iJe i� J i�i�ttiM i!,M 1 i AYrf Ib:J• �!'�t;. I {.:I f.' ! .. •t .cG•d y1 L ',rq 111,r�1 t(: fv'r'' <br /> 'Q11T�CONI&IRMEC' f >�> la E • WA <br /> YES NO REVIEW <br /> (EWED � <br /> Snrsaos • ' <br /> TOTRL P.03 <br />