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y--04V-03/2002 10:23 559268 TWINING LABS PAGE 02/02 <br /> 07-1'7-2001 10:41RM ;:RDI TO 1:-5525371 25 P.OZ <br /> :SAN-ib QUEM COLINTYPUSLIC HEALTH SERVICES <br /> NVIRONmENTALHEALTH PTrISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCK70N CA 95702 <br /> 0 2 k -3 X1(( 10 I (209)468-3420 <br /> PUBLJC RECORDS RELEASE APPLICATION <br /> APPLICANT �f Y I BUSINESS/AGENCY <br /> .ADDPESS S —2 /<reAo J�fs .. YPflzri <br /> PHGNE -2-69- ��aa-/ iW FACSimll-E <br /> _ 1 <br /> TENTATIVE APPOLNTMI9AT AA7E TtiRE <br /> (Plaa3e give 7 t 1p pay data `cation submitlnf) <br /> „ i <br /> ;Q CHECK BOXTO EXPEAI'CE rL--.QUF*-$87.0 -R UEST PROCESS 3 BUSINFSS DAYS <br /> 'SIGNATURE OF APPLICANT OATE <br /> s n r <br /> I <br /> FILE ADDi�cgs TIiIS,SIDE END STAFF USE ONLY <br /> I PROW"ELEMENTS SEARCH <br /> �r4 <br /> S`O rE'� lCJ�-I" 930 4V-- <br /> r <br /> (/ e / Q 1, c o2g� <br /> ' S 2,152 AZ <br /> f i <br /> i <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> NDERGROUND TANK(VST}CLEMUP SITE(LOP) ❑ HOUSING ABATEMENTTE O SCUD WASFACILITY <br /> O;,OTHER CLEANUP SITE(NON-1-OP) j O FOOD FACLI-17Y O SOLID WASTE VEHICLE <br /> ';❑ UNOaRGROUNO TANK(MONITORING/REMOVAL) O DOG KFNNEL 0 DAIRY <br /> ;❑ HAZARDOUS WASTE GeKERATOR I a CHICKEN RANCH G PKG TREATMENT PLANT <br /> !0 TIERED PERMITTED FACILrrY ❑ MOTaMOTEL O PUMPF.fi7RtJGKlYARD1CHE.AM17CIL>wT5 <br /> ILS TATTOMODY PELACING O POOUSPA ❑ LAND USE APPUCX"ON$rTES <br /> :Q MEDIOAL WASTE FACILITY O PUBLIC WA•TFR SYSTEM 0 OTHER{PLEASE SPECIFY A$OY2) <br /> hist up to ten aidoresse�in the space above. Select the types)of files from the 11st above by checking <br /> the appropriate box(es),I At least one file type MUST pe selected. Fax to(209)46"13_8 or snail to the <br /> l addrUo indlcatetl dt3ove.. <br /> ;2. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately five busirless days but no later than ten(10)clays after receipt of appllcation.:The fifes <br /> will be held for a max9mtim of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A fila that is actively beiOg worked on by EHO staff may not be immediately available for review. A new <br /> application may be subal lltud when the file is available. <br /> 4. Any file pat mturned�In the same oorndition as released will be reorganized by EHD•staff at the expenses <br /> of the Replicant. Future ilte reviews by tho same applicant may require a$87.04 deposit prior to review. <br /> *TENTATIVE appointmQrit dates must be confirmed with EHD staff. <br /> Applications received after 3:00 pm will be proaassed the next business day.' <br /> CONFIRMED A-FiFOINTMENT DATE TIME <br /> pAT1CC7N!`LRMEO t PHONE FAX INITIALS <br /> ,kEVIl WED YES j NO. MIEW VATF, <br />