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:Geo-Phase Envi FAX NO. 2095.690295 v Mar. 15 2002 04:30PM P2 <br /> NTYP 11,1,1.1,V iN <br /> 'rlLt�SI�N CES <br /> 04 W AVENUI THIRD FLOOR <br /> 02 MAR 15 PM : 02 ON CA 05202 <br /> (zoo)468-3420 <br /> %f PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT-52-1/6 ZQ.erl'L� -BUSINESSIAGENCY <br /> ADDRESSAV,' I/ "&�, a #,0,?yo <br /> PHONE FACSIMILE d <br /> TENTATIVE"APPOINTMENT DATE I" <br /> TIME <br /> (Please give T to a/ CAW" Tial) <br /> ��{.�!Y1/�,, . . <br /> Lf .HECK BOX TO.FXPC;rrr:REQUEST•$87.00 F--- P SSE S SIN DAYS <br /> SIGNATURE OF APPLICANT DATE14- - <br /> low1 <br /> ��.�W �� 1 ■I --- I �li-� <br /> t FILE AOORESS TH15 SIDE EHD STAFF USE ONLY <br /> a PROGRAM ELEMENTS SEARCH <br /> 01 <br /> 6!f7 ZIL <br /> �. <br /> ,wT <br /> j 44w dOd 4412�y e <br /> t <br /> t ' <br /> ENVIRONMENTAL.HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP WE JLOP) d HOUSING ABATEMENT Cl SOLID WASTE FACILI?Y <br /> DC OTHER CLEANUP SITE(NON-LOP) O FOOD FACU.ITY 13 SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONrroRING/REMOVAL) Q DOG KENNEL M DAIRY <br /> O HAZARDOUS W GENERATOR O CHICKEN RANCH O PKG TREATMENT PLANT <br /> 0 TIERED PERMMV FACILITY O MOTEIJHOTEL O PUMPER TRUCKIYARDICHEM TOILETS <br /> O TATTOQISODY PWRCING O PpOUSPA 13 LAND USE APPLICATION SITES <br /> Q MEDICAL wASTe FACILITY O PUBLIC WATER SYS.TLM O OTHER(NLgAsE SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above. Select the typq(s) of fifes from the list above by checking <br /> the appropriate box(es). At least one file typo MUST be selected. Fax to (209)464-0138 or mail to the <br /> address indicated above. <br /> 2. EHD will notify the applicant if any EHD files axisL An appointment for review will be confirmed <br /> approximately five business days but no later than ton(10) days after receipt of application.-The files <br /> will be held for a maximum of five business days for review. Appointments should be schedulad <br /> accordingly. <br /> 3. A file that is actively being worked on by hHD staff may not be Immedlately available for review. A new <br /> aPPllcation may be submitted when the fila is available. <br /> 4. Any file not returned in the carne condition as released will be reorganized by EHD staff at the expense <br /> of the applicant. Future file revirtws by the same Appilcant may require a$87.00 deposit prior to review. <br /> 5. "TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 1I6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED AP <br /> I POlNTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO RFVli:W naTa <br /> hM a •• <br />