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12/10/20(14 16:56 1066° 329 RYAN & FONG PAGE 02 <br /> tea' 12/18/2084 15:51 46qW8 ENVIROIJPIENTALOMALTH PAGE 01 <br /> •. EM LOG NUMBER <br /> �q <br /> DATE RECEIVED $�),YOAQUIN COUNT].' <br /> E1�rIIt01`MNTA,T,.HTA•I..'I'F�DEPARTMENT � <br /> n l—(';_::u_;�,.',� `,;•-)' 304 E WeberAYe 3 F)oorStoWon,CA 95205 <br /> DEC 10 2004 (209)468-3420 Fax:(209)464-0138 Web:WwW-00-Salt joaquie.ca..us/ehd <br /> ENViR ih'i"i - puBLIC RECO"S REELEASAPPLICATION <br /> PER1,011 <br /> AfWIaCAJIT:i„wa�� ' - BUSINESSIAGENCY: <br /> 1C{ Oo1cS u� 00 <br /> PHONE: 11 � <br /> - 12. FACs a�I0_ <br /> TENTAT[WAPPowtfnsNTUATt:: � f Ta".. — -- <br /> (PIMe allow 1a busir"s 0a9sfrom date of appnc*uon 04tammal) <br /> CHECK 00K TO 190 EDRF RMU •593.00 FEE_REQUW PROCESSED M a BUSWM DAYS <br /> DATE <br /> IGNATURE OF APPLICANT D� use Orgy <br /> UNIT <br /> Fa.E <br /> S"e 1,50 I 0 Unit 11 <br /> Unit 2 <br /> Unit 4 <br /> r. <br /> a L] Unit 5 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> (LOP)CLEANUP UNDERGROUND TANK(US ❑ HOUSNO ARAYEMENT O SOLID WASTE FACILITY <br /> (USMJ ANUP SITE ❑ FOOD FACILfTY 0 S0L1D WAs7r VEHICLE <br /> VOTHER CLEANUP SITE(NONa-OP)NCVREMOVAI) 0 DOG FACIIJ 0 DAIRY <br /> V UtlOERGRouN0 7AHK(MONtTOHI 11 00,G KEN RANCH 0 PKG TREATMEn PLANT <br /> 0 HAZARDOUS WASTE GPNERATOR 0 CHICKEN <br /> ANTFL 0�PER TRUWYARb1CNEM T0lLM <br /> T1EftE0 PERFtriiED FACaxry O pooLwPA LANA UM APPUCATION SITES <br /> ❑ TATTOOlDDDY pIERcaJG 0 OTM(PtF-ASEsprol <br /> 0 MEMALWASTEFACILUY <br /> 1. List up to ton addresses In the space above. Select the type(s)of fifes from the l t above hY checking <br /> the appropriate box(es). At least one file type MUST be selected. F *to(2091 a64-0138 or ma Ute <br /> address Ind(sdTted above. <br /> 2 EHD will notify the applicant if any END fist exist to appointment for ceii sv f;I be colon, ed <br /> approximately five business days but no later than tan(10)days after reoelpt of should <br /> be!a the The files <br /> will behold fora maximum of five business days for review- AP;olntrnenis should be scheduled <br /> acoordingly. <br /> 3. A file that is actively ming worked on byEHD staff may not be Immediately avaUable for review. A never <br /> application may be submitted when the file Is av-:liable, <br /> 4. Any file not retumed in the same condition as released will be reorganized by E"stab at the expense <br /> of the applicant. Future file reviews by Oho same applicant may require a;93-rP <br /> it <br /> 5. `TENTATM appointment dates must h®confirmed with EHD Stall. <br /> U, App(katlons received after 3:00 pm will bo processed the next business day. <br /> fs`flT�Fif�M���F!P ,;, Etif.DATE _•., '' .. <br /> `f]K�CiDNF'It2{4T�U.r;;^. �"��•;;�":'PHONE' FAX'., .. .. <br /> Rf?'1I MED YM NO REVIEW DAYE,,n - s. <br /> 1qfounc4 pit Envi5:erl5. <br />