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l _ No. 2533 P. 5 <br /> S_4NJOAQUINCOUNTY DOLOGNUMBER <br /> EPTVJfftONUMNTAL HEALTH DPPAPTMM --� <br /> C 7 2 0 2005 304 East Weber Aveauq or <br /> 3"Flo ,Stockwo,CA 95202-2709 <br /> �eWpleebet(209)468-3420 Fa::(209)464-0138 Web-www.Sj9eV-0rg/ebd <br /> ENVIRONMENT HEALTH PUBLIC RECORDS RMASE APPLICATION' <br /> P Q <br /> APMJCANT: ttUSINFB&AGENCY: 3( N�k-4; <br /> ADDREas: nok GSA- '77� <br /> PFION!(t): 2o°r� `6kb�_ _W6NE(�:_ 'Zo9--615�i� { .. _FAaawLe: 7.o9V�~33q-�L5"�� t � <br /> TENTATIVE'APPomTuEKT DATE: W y.ZOU� rune: ^��oA <br /> (+maallow tobushmdaysfromdataofappB suanafal- ran <br /> sa Itmonry-Must.becoralmmtli J <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-S9W FPL(CASH OR CHECK ONLY)-REQUEST PROCESSED IN S BUSINESS DAYS W <br /> SIGNATURE OF APPLICANT C DATE71 <br /> lc�Jldl S �t7 0 <br /> UNrt DnUnk1 r3U"VPWUjt3,0WUflk4 OURRI Unite <br /> rj <br /> FILE ADDRE EHD USE ONLY <br /> Sbrrt! stmt Na <br /> 2. �p- <br /> 4. <br /> 6. <br /> 7. <br /> 9. <br /> 9. <br /> #0. <br /> SpactrN Det,Range of information Roque%ted:From S to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNo3GR%noTANf(UST)CLlINurSnROPl O HwunG A"TmF O❑o SbPosUlUMaPrEW <br /> R AMR <br /> PAC MNIREN,;CTLoE <br /> InWAMVTWloyhtoc rSrmtmom- on MFOOD PAMTry <br /> of DNOEN=UW TANK(ON9TWN(AIE,OAL) ❑ Nmm& <br /> M HAzaaWAGe R Q DXwowN CN ❑WASR1AR TREATMENT PLANT <br /> OTIEDPEjaTr"PACtM oe <br /> e s <br /> 12POQL%PA ❑u:w UgEAevuCAnou 3rtEs _ <br /> A pfEOleAe.WadTe AND <br /> WELL 0.ND SEPnC pER,R Rrt:aRoa Arm AYAMBLE Fat REviEw- a0N(IAV-FN1tJAY 8:001w-e:aOrM - E'ta-uflufc K'oAY9. <br /> i. List up W ten addresses In the space abOV& Select the type(s)of files from the Iles above by checking tete <br /> appropriate box(es). At least one rte type MUST be selected$ ax dFdotnat assistance with fl lladdressesdd,c ct <br /> Ind d above. Address ranges will not be accepted <br /> the EHD.Applications received after 9:00 pm will be processed the next business day. <br /> 2. The FHD will notify the applicant H any EHD files exiat An appointment for review will be conNrmed <br /> appwttmatery ten(10)days after receipt of application. The files will be held for a maximum of five busbies* <br /> days for review. Appointments should be scheduled accordingly. <br /> 9. A file that Is actively being worked on by EHD staff may not be immediately available for review. A new <br /> application may be submllEed when the tie is avallable. <br /> 4. applicant uhtre fl eln the same condition Ss relessed will be reorganized by EHD reviews by the same 8pp(tcalnt may require a$93.00 dePOSIt p�to f ateview.expense Of the <br /> rao<amam <br /> XIIIIer <br /> E0/T0 39Vd T1906EE60Z 84:60 900Z/0Z/0T <br />