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t1FF <br />J� � ... .: u ,,. ♦i'c: fl�ul'i lU Lei J:iJ1'j4a4 N.til <br />- -SAN SQUIN COUNTYPUBLIG HEALTH SOCES <br />ENVIRONMENTAL HEALtH DIVISION <br />I Mi AR Q 2001 304 FAST WEBER AVENUE, THIRD FLOOR t' �� <br />STOCKTON CA 95292 '"'� <br />H (209) 488-3420 <br />FtHP�iIT;:,r': PUBLIC RECORDS RELEASE APPLICATION <br />LPPLICANTMike•gren; BUSWESWAGENCY P.euahaw Associates, Inc. _ <br />�toDRt a 11875 Dublin^ Bvd, Suite A-200, Dublin, CA 94568 _ �-y • <br />HONE � — +J.J •JL77Z FACSIMILE J'+ � ~ - `�� <br />i <br />�{i FTS 0n <br />TENTATIVE' APPOINTMENT DATG .3/.S d / lima 2, o o AM <br />I (Phase Slv4; T to 10 business days from 660 of appnailvn submittal) <br />pCHECK BOX TO EXPEDITE RE <br />SIGNATURE OF APPLICANT <br />li- <br />h1k3G3�► `iJ ffifla 3iI G�tf <br />�uMwl'ETED <br />t ENVIRONMENTAL HEALTH DI /ISION FILES <br />�f UNDERGROUND TANK JUST) CLEANUP SITE (LOP) <br />OTHER CLEANUP SITE (NON -LDP) <br />UNDERGROUND TANK (MONrTOR1NCIREMOVAL) <br />HAZARDOUS WASTF GENERATOR <br />❑ TIERED PEP.Mr1TEO FACILITY <br />17 TATTOOIDODY FORCING <br />0 MEDICAL WASTE FACILITY <br />N <br />N <br />O HOUSING ADATFMEI IT <br />❑ 30LIO WASTE FACILITY MAR 13 <br />❑ FOOD FACILITY <br />0 SOLID WASTE VEHIGLG <br />❑ DUG KENNEL <br />❑ DAIRY <br />❑ CHICKEN RANCH <br />❑ PKG TREATMENT PLANT. <br />❑ MOTEIJHOTEL <br />❑ PUMPER TRUCKlYARDKCHEM TOILETS <br />❑ POOUSPA ' ' <br />❑ LAND USE APPLICATION SIT" <br />0 PUBwc WATtiR'1iYS'.'EM <br />O 40YHOR(PLF.ASE SPECIFY ABOVE) <br />I. List up to tan addresses In the space above. Select the type($) of files from the list above by checking <br />the appropriate box(es). At least on/ file type MUST be ;elected. Ella to 12091 464-D130 or mail to the <br />adttlmA lodicated above. <br />2. EHE) will notify the applicant if any EHE) files exist. An a 7pointment for review will be Confirmed <br />approximately five business days but no later than tan (10) days after receipt Of application. The files <br />will be held for a maximum of five business days for rev ew. Appointments should be scheduled <br />accordingly. <br />3. A file that is actively being worked on by ENO staff may not be Immediately available for review, A new <br />application may he Submitted when the file Is available. <br />A. Any file not returned U the name condition as released,vlll be reorganized by SHO staff at the expanse <br />of the applicant, Future file reviews by the soma appilci nt may require $87,00 deposit prior to review. <br />5. 'TENTATIVE appointment date6 MUG% be confirmed with EHD staff. <br />6. Applications rcceived after 3:00 pm will be, processed 0 a next business day. <br />CONFIRMED APPOINTMENT DATE TIME <br />GATE CONFIRMED PHONE FAX INITIALS <br />REVIEWED YES NO REVIEW DATE <br />TOTP.L' P.01 <br />