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Jun - l8 . 2003 4 57P CONDOR EARTH TECHNOLOGIES N ; .4)08 1 , I <br /> OA TE RECEtVF_D <br /> elw I.OG nu wB�R <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICI , <br /> ENVIRONMENTAL HEALTH DWISiON <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKT ON CA 95202 <br /> JUN 1 .� 200; . (.209) 463-3.420 13q I <br /> PUBLIC RECORDS F!ELEA,SE A,.PPUCA710M <br /> , , ' HJ4(N51�.6=YAPPLICAAICI _12A�Q" r <br /> PHONE <br /> TENTATNE*APPdINT tw DATE ;k-Q_ Lk <br /> D t 1 <br /> (Pieasa give 7 to 10 bu3inqy dad sfmtt:date atapplicatioci$ubiitit;al) <br /> 71 CHECK BOX TO EXPEDITE REQUEST-SS7.00 FEE—RI=QUt�Sr?ROC;=SSED IN 3 BUSINESS[1,A7'3 0 <br /> SIGNATURE Olr APPUOANT Cr;l"E? <br /> FILE ADDRF= THrs 511 E IaiD:;1*)1k'I--USE ONLY <br /> MOGRMf.Ell:IIENT1;5e RCH <br /> 1-7-31 <br /> Qr =Imd Opp <br /> _ <br /> do V, <br /> E14VIPZONMENTAL HEALTH DIVISION 1~IL.V <br /> 1 UNDERGROUND TANK(US-n CLEANUP SITE(LOP) 1� HOUSINGJOATEMENT SOLID wA:'. FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) 0 FQOp FAC UTY �soi.to YiA'',m L'mci_.E <br /> UNDERGROUND TANK(MCNITOMN135ZEMOVAL) 0 DOG KENNEL 0 DAIRY <br /> HASAPMOUS WASTE GENERATOR Q CHICKEN FANCH Q PK(;TRIiA;MEN r PLANT <br /> TIEMD PEPmr TED FACILITY Q r4oTEL-Ho rEL PUZIPI_R TI;UCYUI',ARVJCHEY1"r0IkZ a <br /> TATTOO/HODYPEIRCING CI POOLISPA G LAPID USE,IPPLIC:ATION SFIES <br /> MEDICAL WASTE FACUTY Cl Pu8LIC YY11,TER SYSMI 1: 01-IIER(PL .-A!U_';iFEC3 YA60VE) <br /> List up to ten addresses in the space above. Sclect the type(s) of files fior.I tho list above by che;•ckin!3 <br /> the appropriate box(es). At least one file type �IYUST be selec--ed. Fax to.L2g2-. 643 0.1 38 or mail"to the <br /> address indl"ted above. <br /> EHD will nbtify the applicant if any EHD fife_; exi.;t An appointment for mvi ew nrill I>I! confirnaec! <br /> approximately five business days but nu later than ten (10) days after rc+:ai pt W tapplicmilon. The Me* <br /> will be held for a maximum of five business day:;for review. Appointment:; shiiuld tie scheduled <br /> accordingly. <br /> A file that is actively being worked on by EMD stiff may not be immediat,::ly ay.3 ilable"for revifaw. A ni3w <br /> application may be submitted when the file is available_ <br /> Any file not returned in tho same condition as released will be reorganized by i:HD stiff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a $137.011 dcpasit prior to revirwx. <br /> *TENTATIVE appointmena dates must be-confirn ed with EHD staff. <br /> Applications received after 3:00 pm will be processed the next business ,lay. <br /> QNFIRMED APPOINTMENT DATE TIME <br />