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DEC. 8. 2003 2: 16PM CONDOR EARTH TECH N0. 16 a-ic INUMBER <br /> DATE RECEIVED SAN JOAQUIN COUNTY <br /> _j) 171 ri F,z:j i N-VMONVTMALRZALTHD"TM^ <br /> _j ! . E <br /> LL _ <br /> o <br /> 304 E Weber Ave 3`1 Floor Stockton, CA 95205 <br /> 1)E 0, <br /> 468-34210 Fax: (209)464-0138 Web:wWW-co.san-jOaqI1in-ca-us/ehd <br /> u <br /> PUBLIC RFcORJ)S RELEASE APPLICATION <br /> Z_ Y. <br /> APPLICANT. C=, <br /> SUSINESSIAGENC <br /> TT <br /> r?, L, <br /> ADDRESS: <br /> ., 9�SX�� <br /> PHON FACSIMILE <br /> TENTATIVE-APPOINTMENT DATE; Time. 50 A.94 <br /> (Pimse aiiow 10 buslness d%sirom dam of application submittal) <br /> FILE C " <br /> M CHECK SOX To EXPEDITE RizaurzSj�- 93.00 FEE—REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> DATE _Tber_03 <br /> SIGNATURE OF APPLICANT --_z, oepatnest use only <br /> FILE ADDRESS UNIT <br /> �. Street <br /> 2. Sirmi <br /> Unit 3. street tt 3 <br /> !15'7 111 If .5pyUlic <br /> Uni <br /> tuni3 <br /> e. Street o G <br /> C1nit 4 <br /> 7. Svcctp4u <br /> a. Strset Unit 5 ak� 11L <br /> .9. sbw O C&Lvl-_ -C� <br /> io. strut 0 t <br /> ENvIRONMENTAL HEALTH DEPAFrrMENT FILES Slu <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LDP) E3 HOUSING ABATEMENT SOLID WASTE FACIIJITY <br /> OTHER CLO-ANUP SITE(NON-LOP) t3 FOOD FACILITY SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGMEMOVAL) 0 DOG KENNEL 13 DAIRY <br /> 13 CHICKEN RANCH <br /> El PKG TREATMENT PLANT <br /> HAZARDOUS WASTE GENERATOR <br /> TIEPXD PERMITTED FACILrrY C3 MOTEUHOTE!L L3 PUMPER TRU`CKJyA1W1GWM TOILETS <br /> IM <br /> 0 TATTOO/BODY PIERCING 0 POOLISPA 0 LAND USE APPLICATI10STrIES <br /> 13 OTHER(PLEASE <br /> 0 MEDICALWASTE FACILITY <br /> 1. List up to ton addresses in the sPads above. Select the type(s)of files from the Ilst aboye checking <br /> the appropriate box(es). At least one Me type MUST be selected. Fax to(209 4�641)138 or 8_12711 to the <br /> address Indicated above. <br /> 2. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten(10)days after receipt of appricatioirL The files <br /> will be held for a maximum of five builness days for review. Appointments should be sch F dulled <br /> accordingly. for review. Anew <br /> 3. A file that is actively being Worked on by EHD staff may not be immediately available <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$93.00 depo,-dt prior to:review. <br /> S. '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 /> .1 <br /> CONFIRMF-D APPOINTMENT DATE TIME <br /> DATE CONFIRMED 'PHONE - FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE' <br /> 01)4"2-006 <br />