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Torn: <br /> 07/9007 14:02 11406 P.001/001 <br /> wa+vrvnT"runt TruaLIU If -ALTH BE <br /> CIN ENVIRONMENTAL HEALTf1 DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOC1tt <br /> STOC1(TON CA 95202 <br /> r, PUBLIC RECORDS(209)RELEASEAPPLICAT O zo40-U20 FAX0136 J O P, <br /> APPLICANT Z— fBUSINESS/AGENCY ? <br /> ADDRESS P.t�. (jb 06 (,.0dS^Z/Y <br /> PHONE _--� /S 7 FACSIMILE <br /> TENTATIVE-APPOINTMENT DATE TME <br /> (Ptuse 0-4,t-w business days Iran dale of application eubmltlal) <br /> CHECK BOX TO EXPEDITE REOUE : F O PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 7 <br /> FILE ADDRESS THIS SIDE Elio STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH 11 <br /> 6 s- J� <br /> / ENVIRONMENTAL HEALTH DIVISION FILES <br /> ! RGROUNO TANK.IUST)CLEANUP SITE ILoP) 0 ROUSING ABATEMENT 0 SOLID WASTE FACILITY <br /> a CLEANUP SITE MON•L" O FOOD FACILITY 0 SOLID WASTE VEHICLE <br /> ROUND TANK(MONITOWNOMEMOVAL) O DOG KENNEL 0 DAIRY <br /> HAZARDOUS WASTE GENERATOR O CHICKEN RANCH 0 PKC TREATMENT PLANT <br /> 0 TIEREDPERMITTEDFACILITY 0 MOTEIMOTEL 0 PUMPFRTRUCKIYAROMHEM TOILETS <br /> 0 TATTOORIODY PEIRCING O POOLISPA 0 LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY _ ❑ PUBLIC WATER SYSTEM 0 OTHER(PLEASE SPECIFY ABOVE) <br /> 1. list up to ten addresses in the space above. Select the types)of files from the list shave by'checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the <br /> address indicated above. <br /> Z. EHD Will notify the applicant H any EHD Ries 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 Ries <br /> will be held 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 be immediately available for review. A new <br /> appacaUon 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 some applicant may require a 689.00 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"mie r DATE. TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> PIM-h'Fax Nate 7571 Wm wu"mp <br /> Tq T,0r11 &A fW11A <br /> roans r Pinna s <br /> cve Za 5 333 OL(y 2 ..shy. Lifn4 -D!� <br />