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FROM Geo—Phase Enwirr,rnentaE - <br /> , .�����fC /��� FAX N0. 2J55E�90295 Oct. 16 2000 12:48PM Pc <br /> 1LV I+�'Sj� AN JOAQUIN COUNTYPUBI_IC HEALfiRVlCES <br /> ,'H SE cnU���L�'�H <br /> ENVIRONMENTAL HEALTH DIVISION <br /> OCT 1 6 2000 304 EAST WEBER AVENUE,THIRD FLOOR <br /> ENVIRONMENT HEALTH s70CKTON CA 95202 <br /> (208)468 420 <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT <br /> BIISINESSIAGENCY �+ o <br /> ADDRESS <br /> PEiONE FACSIMILE S <br /> TEN TA1EVE Af'PQINTA3EhlTpATE_ 7:/j, f r:ME <br /> IPleare 11ivo 7 to 10 business days frertl data Of 2Pplication submittal) <br /> CHECK BOX TO 5-.XPED1TE REQUEST•378.00 rEr=—REQUEST PROC SED 1N 3 BUSINESS DAYS <br /> SIGNATUPE OF PPLI y J_ <br /> A CANT /`� `�"�/ DATE �40 <br /> . <br /> FILE ADDRESS <br /> !I <br /> ------------- <br /> i <br /> I� <br /> l t <br /> ENVlRs'3hIME TAL HEALTH DIVISION FIi ILES <br /> }� UNDERGROUND TANK(UST)CLEANUP SITE'(>,OP) 0 HOUSING ABATEMENT 0 SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) D 1:001)FACILI"fY 1l SOLID WASTE VEHICLE <br /> 0 UNI IERGROUND TANK(MONITORING/REMOVAL) 0 DOG K6NNr=L ❑ DAIRY <br /> 'J HA2ARDOU5 WAS T4 GENERATOR 0 CHICKEN RAN C-14 3 0 PKG TREATMENT PLANT <br /> TtERED?ER,MITTED FACILITY 0 MOTF-VI40TEL Q PUMPERTRUCKfYARDICHEM TOILETS <br /> Ca TATT001500Y PEIRCING 0 PO4USPA M LAND USE APPLICATION)SrrES <br /> M MEDICAL VVA5TE FACILITY 0 PUBLIC WATT-Ft SYSTEM .1 0 OTHER(PLEASE SPECIFY ABOVS) <br /> i� <br /> 1 List up to len addresses in the space above. Select the type(s)of, files from the list above by checking <br /> the applropriate box(es). At least one file type MUST be selected. Fax to 209 464-0138 or mail to the <br /> address indicated above. I] <br /> 2. EHD will notify the applicant if any EHD files 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 five bu3iness days for review. Apliointments should be scheduled fff <br /> accordingly, <br /> 3. A file that is actively 6cing worked on by EE"ID staff may not be immediately available for review. A now <br /> application may he submitted when the Ile is available. <br /> a, Any rile not returned in the same condition as released will be reorganized by EHD staff at the expense <br /> of the app(tcarlt. Future file reviews by the same applicant may r6quire a $78.00 deposit prior to review. <br /> 5. *TENTATIVE appointmcnt dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOIhITMVNT DATE TIME <br /> DATE CONFIRMI"D PHONE FAX INITIALS � <br /> REVIEWED YES NO REVIEW DAT; <br /> Ex OD 14 olio�f00 <br />