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iu <br />04'.:,�N FROM LHti Luy N�JtM1Is�H <br />J _ ,, �r SAN J AQUIN COUNTYPUBLLC HEALTH i�V1Cl=S <br />ENVIRONMENTAL itF�LTH DIVISION �j <br />304 EMT WEBER AWNUE, THIRD FLOOR�� <br />61;60KTON CA 95242 ��JJ <br />MAR 19 2001 (209) 46&3420 <br />PUBLIC RECORDS RELEASE APPLICATION <br />" '`� ^` ` 1 usll�Essrnal:l�icY c <br />'APPL1fr:4NT ` n n .. . rn <br />ADDRESS <br />PHONE <br />TCIVTA: 1v E' APP6'xTArsNTDA'r2 <br />(Floasc glvo 7 La 10 bcwine,s d: <br />12 CHECK aOX TO EXPEDITL* P.1r.Cl -�f.0p FEE -- <br />SIONATURE OF APPLI-CAWT <br />oma' <br />Soon�r:'� Tk�iB �. P1l Y r F <br />aam of apgllcauon auAmkbaj? <br />Fft0CES3El3 IN 3 BUSINESS DAY -5 <br />DATE-� <br />PRf1GRAM ELEMP-WS SEARCH <br />��1Ts fi�_i!�' ►tel -WpxjwmkzmL�YRwmm� was <br />OWN N <br />Wt "O�Jqj Normlis <br />IV IM <br />ENVIRONM- TAL HEALTH DiVISICJN FILES MAR 2 7 2001 <br />UNDERGROUND 1'A!4.K (UST) ?,-LLANUP 51TQ' (LOP) b HOl1SiK6 A13ATF-MF-N7 Ck 'JOUP WASTE FACIL[TY <br />4TH R V.. AKUP SIVE (NON -LOP) 0 FOPD PACii.7TY 0 SOUR WASTE VI CHICLE <br />jll0fg0KQ 5ND TANK tMQNCTQI1LNCl=b1OYAL) M DGG KENNEI, Q DAIRY <br />HAZARDOUS WAST)= GENUP,?,T©R 0 CHICKEN RANCH 0 PKG TRYAniENT PLANT <br />TIED PERMITrW FAGKJTY G Id0T91JIi0TEL Q PUMPER TRUCWYARDJCHEM TOU.EM <br />U TATTOO(SODY P7EIROING a PdouSPA ❑ LAND USE APPLICATION SIT64 <br />U MEDICAL WASTE FACIUTY G PUEUG WATER SYSTEM Q OTKER (PL5A.SESPECIFYABOVE) <br />1. List up to tern addresses In the space above. Select the type(*) of files from the list aboVe by 0heching <br />tha appropriate box(es). At feast one file type MUST be selected. Fax,to (202) 4S+M938 qr Mail to <br />-4djdr4@y,s indiGBt §%gye <br />2. EtiD will notify the applicant if any EHD file$ exist, .Art appointment for rkeviDw WIJI he GVtitirmed <br />approidm,atsiy five business days but no later than ten (10) days after receipt of apglicamon. The flies <br />will be held for a maximurn of fives buslaess days for r,9view. Appointments should bo scbeduled <br />aGCorclingly. <br />3. A file that is activaly being worked or, l?y EHD staff may not be immediately available for revlew. Anew <br />appl"icallon may be submitted when the file is avallable. <br />4, Any file not retuened in the same condition as released will be recrgonIzed by CHH staff at the wcpanse <br />of the applic�Lnt. Future file reVlews by the sable applicant may require .a $87.00 depovit prior to review. <br />S. *TEr4TATNE appointment dates must be confirmed with END staff. <br />B, Apphoatlons recelved after 3:00 pm will be processed the next business day. <br />CONFIRMED APFo6%TmtRmT*DATE -TIME <br />DATI; CONFIRMED PHONE FAX INITIALS <br />REVIEWED YES NO REVIEW DATE <br />ar w — Dasa <br />TOTAL P. 01 <br />