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I <br /> J 8 2003 4 57PM CONDOR EARTH TEv>NOLOGIES N'. 4 0 8 <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SE RIM Cj::S <br /> ENVIRONMENTAL HEALTH DIVISION <br /> [T. 204 EAST WESER AVENUE,THIRD F1,00R <br /> -7 <br /> STOCKT:)N CA 952'02 <br /> ,JUN 1 '8 2003 (209) 468-34;20 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> ','illr")'11 J <br /> APPUCANTF <br /> BUSINIES&A.GiENCY <br /> 61 <br /> ADCRESZ U-P_S� <br /> PHONE <br /> TENTATIVE,Appowrmtw DATE <br /> 0 <br /> (Ple.-L-a give 7 to 10 businqy dales from date at appII=jjofj 3ubjjjjt:s1j) <br /> 0 <br /> lk <br /> ED CHECK • <br /> BOX TO EXPEDITE REQUEST-387.00 FEE—RJEQUE�; 'jR0CE55ED IN 3 BUSJWSS GAYS <br /> AA (I <br /> SIGNATURE OF APPUCANT <br /> FILE ADDRE= 7liUS sic 1=IjiD:;TAFF <br /> USE 0MLY <br /> .10 <br /> oe-AN <br /> licto I t"O!2d iA 2a'T-rA <br /> A U 61 O+e A)o V, <br /> ENVIRONMENTAL HEALTH DIVISION M-,U' <br /> I, UNDERGROUND TANK(US7)CLEANUP SrM(LOP) Cl H0U--1NGJJ3ATEWNT SOLID WA!'TE FAMLTIN-Y <br /> OTHER CLEMqP SITE(NON-LOP) 11 FOOD FAC I" SOLID <br /> WA:'mL'lEmcLF- <br /> UNDERGROUND TANK(mcwrORINGREMOVAL) Cl DOG KENNEL 0 DAIRY <br /> �HAZARUOIJS WAS-M GENERATOR 0 04MXEN 1;'ANCH C PK(, T[xE ',-Mi7al'rPLANT <br /> TIERED PERMITTED FACILITY 0 AdOTELaicrEL M PUN.PV-R TF!UCkU1'fiRVJGHE:Y1 70I F73)^ <br /> TATTOO/BODY PFJRCING IJ POOL/SPA -- - C1 LAPIO USE,IPPLIC-AnON 511-TES <br /> MEDICAL WASTE FACILITY C1 PU13LIC W;,TF-R SYSTEM 1: OTIIER(PLAS1:ZFEC3FYA6OVE) <br /> List up to ten addresses in the space above. Select the type(s) of files frora till: 11,Ft above by,CbW-k:li7I!3 <br /> the appropriate box(es). At least one file type MLIST be selected. Fax to.L2g2j.,!fi4:L)j:38 or mail-to tri <br /> address indicated above. <br /> EHD will n6tify the applicant if any EHD fifes exi:�t An appointment for rwfew All Ix?confirmee, <br /> approximately five business days but no later ttian ten (10) days after refeipt c0zi-pplicailon. The flk):s <br /> will be held for a maximum of five business day.,; for review. Appoint.mwit:t: sh(iuld tie scheduled <br /> accordingly. <br /> A file that is actively being worked on by EHD staff may not be immediat::ly av-,idable far,review. Anim <br /> application may be submitted when the file is available. <br /> Any file not returned in the same condition as released Will be reorganized by 1:,-HD stiff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a $137.011 clelxn5it prior to revfi-iv. <br /> *TENTATIVE appointment dates must be-confirmed with EHD staff. <br /> Applications received after 3:00 Pm will be processed the next business ;lay. <br /> ONFIRMEI) APPOINTMENT DATE TIME <br />