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rn 40 <br /> OCT 2 0 2000 <br /> U <br /> . ..... <br /> AN JOAQUIN GOUNTYPUBLIC HEALTH SERVICE$EUVIRQNMENT HEALTH <br /> PERMIT/SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 704 EAST IN <br /> EBER AVENUE,THIRD FLOOR <br /> nTOCKYON CA 95702 <br /> (209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APeLL.7CAN nj e. <br /> e <br /> ,cODRESS <br /> � <br /> iENIAItVE' APPOIW.MENTDATP. �' 11W.F. <br /> iPieOSO give T 1010 bul-iness days fr M dale at appiicatiOn 3v0XdlJIj <br /> CHECK BOX TE)EXPEDITE REQUEST 87.DOFEr'—REQU P 0 ES BUSINESS DAYS <br /> ��ESTN BU <br /> SIGNAWREOFAPPLICANT LIA I'E j 0 <br /> STAFF ONLY <br /> PrOGRAM Ft FNIENTS WARCIt <br /> A <br /> L <br /> A; <br /> .. ........ <br /> co� r <br /> q.I, <br /> ENVIRONMENTAL HEALTH DIVISION FILLS <br /> ,16 UNDERGROUND-TANK(UST]CLEANUP SITE(LOP) 511,HOUSING ABATEMENT M SOLID WASTE FACILITY 1:1 <br /> ZOTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY 0 SOLID WASTF.VEHICLE 41, <br /> UNDERGROUND YANK(MONITORINGfREMQVAL) C DOG KENNEL 0 DAIRY <br /> tA HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH 0 PXf,TRFATMENT PLANT <br /> 0 TIERED Fll:RMI'f1 ED FACILITY is MOTELIH07EL On PUMPER TRUCKNARDICHLM TOILETS <br /> 0 TAI fOO)BODY PEIRCING 0 PMI.I.';PA <br /> 99 LAND USE APPLICATION Silas N <br /> 0 MEDICAL WASTE FACILITY t>PUBLIC WATER SYSTEM 0 01 HER(PLEASE SPECIFY ABOVE) fC <br /> 1. List up to tot) addresses in the space above. Select the Itype(s) of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected, Fax to_(2 <br /> address ind.�L .­­.. <br /> 2. EHD will notify the applicant if any EHD files exist An appointment for(OViPW Will be confirmed <br /> aPPr0XJI'r1ateiy five business days but no later than ton (10)days after receipt of application. Thefile.,j <br /> will be hold for arnaxinium of five business dayr,for review. Appointments should be Setleduled <br /> 3. A the that is actively being WOtkgd on by Ek-10 staff May not be immediately available for review. A new <br /> application May be submitted when the file is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by L-HD b(aff at the expeDse <br /> of the applicant. Future file reviews by the same applicant may require a $87-00 deposit prior to <br /> 5. •1 EN'I WIVE appointment dates must be confirmed with EHD Staff. review, <br /> 6, Applications received after 3:00 pm will be PrOCASW the next butinelss clay, <br /> i PONFIRPAED API h TE <br /> IME <br />