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From: 07/VS007 14:02 #406 P.001/001 <br /> —or-4vit-%ovum i T rutsut;titALTH 5F_ <br /> s <br /> YUT 2007 <br /> V ENVIRONMENTAL HEALTH WOWit <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> ON5 <br /> CIO <br /> STOCKMN CA 95202 <br /> (209)468-3420 FAX (7.09f)444"013 81 <br /> PURLIC RECORDS RELEASE APPLICATION MD <br /> I <br /> APPLICANT - BUISINESSIAGENCY <br /> ADDRESS Uc)d_� Q, , <br /> PHONE 37:) -1 Ir FACSIMILE_&jT 33 Z. <br /> P" <br /> TENTATIVE*APPOINTMENT DATk 7—I®-0 7 TIME <br /> (Please gee 7 to 10 buSinoSs days from dole of appftation isubmittal) <br /> CHECK BOX TO EXPEDITE REQUEnlIMN PROCESSED IN 3 BUSINESS DAYS <br /> CHECK <br /> OF APPLIC DATE <br /> ,ANT 7-6 - 0 -7 <br /> FILE ADDRESS THIS SIDE EHD VAff USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> n <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> �ERGROUND TANK(UST)CLEANUP SITE(LOP) C3 HOUSING ABATEMENT 0 SOUL)WASTE FACILITY <br /> ot <br /> MI <br /> It CLEANUP SITE(NON-Loo) 13 r*00 FACUTY 0 SOLID WASTE VEHICLE <br /> ROUND TANK(MOMMMMMEMOVAL) C3 DOG KENNEL 0 DAIRY <br /> HAZARDOUS WASTE GENERATOR 0 CHIC MW RANCH 0 PKG,TREATMENT PLANT <br /> 0 TIERED PERMITI150,FACILITY D MOTEL)HOTEL D PUMPER TRUCKIYARWCHEM TOILETS <br /> 0 TATTOWBODYPEIRCM 0 POOLJSPA 0 LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY 0 PUBLIC WAnR SYSTEM Cl OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ton addresses In the space above. Select the type(s)of flies from the list above by'checking <br /> the appropriate box(er.). At Isest one file type MUST be selected. Fax to( 914 1 al gr mail to the <br /> 20 6" <br /> address ingfiyM ykM.' <br /> 2. EHD Will-notify the applicant If any EHD flies exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten(10)days after receipt of application. The flies <br /> will be hold for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that Is actively being worked on by EHD staff may not he immediately available for review. Anew <br /> application may be submitted when the file 19 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 some applicant may require a$89.00 deposit prior to review. <br /> 5. *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 /> CONFIRMED Appo"mENT DATE. TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEWDATE <br /> ftat4e Fax Note 7671 <br /> t <br /> T9 FWM A <br /> Q)ll)apt. U L4 L)_ <br /> PhOM 8-aek <br /> �l 3-91 <br /> F-6 0Y9 -a.I <br />