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Apr•15. 2004 10:56AM Ne' Anderson & ASSOC. No•4781 P. 2 <br />• _ � � SAN 30 UIN COUNTYPUBLIC -HEALTH SERItS <br />ENVIRONMENTAL HEALTH DIVISION <br />304 EAST WEBER AVENUE, THIRD FLOOR <br />STOMTON CA 85202 <br />APR 1 5 2004 (209)448 -WO <br />La��H PUBLIC kECORDS RELEASE APPLICATION <br />,AP_ PLICANT�S� w G\� susrNE;6SfAGddCY <br />ADDRESS G O 2 `=r Ls+ri a` I—CA ` CA 1-1:15 2`/0 <br />i.......�..w d.. �........7— PHONE ' 3 - FAcsIN,aILE Za 3 �, z.2.8 <br />TENTATSM APPOINTMENT DATE Ahc;t 2_6, 2002- -nmF- S A M <br />(Please give 7 to 10 bminoss days from date of applioWon submittal) <br />CHECK BOX TO EXPEDITE REQUEST 0 FE — RE ESSED IN 3 BUSINESS DAYS (W'+ <br />PROC <br />SIGNATURE OF APPLICANT " DATE /S � <br />„• m F USE ONLY <br />M' SEARCH <br />ENVIRONMENTAL HEALTH DIVISION FILES APR 2 9 2004 <br />jYyMDERGROUND TANK (UST) CLUNUP SITE (LOP) 0 HOUSING ABATEMENT �0UD WASTE FAC&ITY <br />�_QTNER CLEANUP SITE (NOIt-I.OP) ® FOOD FACILITY L SOUP WASTE VEHICLE <br />= DERORQUND TANK (MiONITQRINGIREMOVAL) ® DOG KENNEL O DAIRY <br />HAZARDOUS WASTt_ G1rt1ERA7�t D CMCKEM RANCH O PK® TREATMENT PLA9T <br />ID nt=rtED rER�nr T PAC1L17Y O MOTELIHOTEL ®PUMPER TRUGKrYARD/CNEb1 TOBLE73 <br />O TATTOO/BODY PEIRCING 13 VOOLISPA C1 LAND USE APPLICATION SITES <br />13 MIDiCAL WASTE FACILITY b PUBLIC WATER SYSTEM ® OTHER (PLEASE SPECIFY ABOVE) <br />1. List up to ten addresses In the space above. Select the type(s) of files Rolm the list above by checking <br />the appropriate box(as). At least one file type MUST be selected. Fax to(209) 484.0138 or mail to the <br />5¢gEe22 111910 <br />11dd above. <br />2. EHO will notify the applicant if any EHO fifes exist. An appointment for review will be confirmed <br />approximately five business days but no later than ten (10) days after receipt of application. The files <br />will be held for a maximum of fire business days for review. Appointments should be scheduled <br />aocord'Ingly. <br />3. 'A file that is actively being worked on by EHD 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 condttlon as released will be reorganized by EHD staff at the expense <br />of the applicant. Future file reviews by the same applicant may require a $89.00 depogit prior to review. <br />S. "TENTATIVE appointment dates must be confirmed with EHD staff. <br />6. Applications received after 3:60 pm will be processed the next business day. <br />CONFIRMED APPOINTMENT DATE TIME <br />REVIEWED YES NO <br />REVIEW DATE <br />INITIALS <br />Am <br />N <br />