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N-13-2000 16:39 FRI M:TAINING LHBS, itll- t`DJ-cbU-fi b I u: Dlj b r=1r-t+c�or -I ` -' <br /> 06-23-2000 03:44PM L7M TO _h 71 ?P. <br /> LKU Lk ED <br /> SAN JOAQUIN COUNTYPU13LIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION J'113 2000--'L� <br /> 304 EAST VVEBERAVENUE,THIRD FLOQRF-NVIRQ(VMt(NTAL HEALTH <br /> S`fOCKTflN CA 952= <br /> (209)4983PF420 R�.4I T /SERVICES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICA."lTt� '- j L ,BL{511�SS<AC�EK4`Y W l r1 1 <br /> ADDRESS t 5 oL� i�`CA►a �I�'•� � <br /> PHONE 5�-C�G �ti' FACSOALIE I <br /> 'E=N7ATlvc:"APP9ANTMLNT DATE -. T IML <br /> • (PI"Se ave 7 to 10 busir"s days from clic¢of jLFAcattion subaunaR) <br /> CHltGli BI X 70 E)(PEI)tYE R QUEST-S7"F QUES R20CES3E0 W 3 BUSiXE5S DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> FILE AAORESS THIS$IDE LM STAFF USE ONLY <br /> PROGRAM ELFJAI 7NTS SEARCH <br /> �d� s <br /> 1 <br /> ENVIRONIh1ENTAL HEALTti DMSION F11-55 <br /> UNDEROROUND TANK{UST)CLEANUP SRTE(LOP) O rbuStHG ARATF-MH dT 0 gaUD WASTEFACaJTY <br /> C3 OTHER CLEANUP SITE(140N-LOP) ❑ FOOD FALAI ! ❑ SOLID WASTE VrMt= <br /> 0 UNDE.ROROtJril)VAUK(M0?,LrC0fMNCdREMOVA-Q 0 DOG kftlNEL O DAIRY <br /> ❑ HAZARDOUS VIASTE GENTERATOR ❑ CHiCRtEf4 RANCH ❑ PKG TrtFATKLN T PLART <br /> ❑ TIERED PERMITTED FACJLrrY 0 Irol"E04MEL p PUMPER 77tLJCRUYA.q 7CM1YOU=- <br /> © TATT0000)Y PFJRCtMG Q POC)L SPA U LAND USEAPPLIGATROH SrF" <br /> ❑ MMOIC-1ki-WASTE FACILITY O PUW-10 WATER SYSTEM Q OTHER(PLFASE SPECIFY A13OVE) <br /> I. 1. ZI up to ten add,-ess.--s in the space above. SQIQCt the types)of files from Lie list above by checking <br /> the appropriate box(es). At feast ono file typ9 MUST be salected. Fax to fess)4U-0138 or mall W ttTip-- <br /> address indicated above. <br /> 2. eKD will notify the applicant if any EHP files midst An appolntrrlont for review WJB be Confinntd <br /> approximately live business days but nD later than ten (10)days after re;eipt of application_ The f leS <br /> will b$hetd fo;--t3 ax—I;1uTi of five business days far review. Appoinfrn, ants should be szhod"I9d <br /> accordingly. <br /> 3. A file that is activeoly being workad e:s by EPO staff may not be irnmiadiaiely available for review. A tww <br /> application may bo subrnitted Mien tho file i5 ava! la. <br /> 4. Any file not returned in the same condition as released will be reorsanizod try EHD staff at thQ eYpensa <br /> of the applicant_ Future file reviews by the same applicant=y require a$78.00 deposit prior to review. <br /> S. `TENTA71VE appo la maftt dates nw-st be confirmed With EHD Staff- <br /> s. Ap s1lc2ti€sa��rcaeivad after 3:00 pm will be pro ed the React business day. <br /> f CONFIRMED APPOINTMENT DATF- TEME <br /> iDATE CONFIRMED PHONE TAX IN MALS <br /> fes=lllEV1ED YES NO REVIEIN DATE <br /> Tore P.01 <br />