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06/10/2003 17:58 9252836121,, AEI CONSULTANTS (`.>> s_ PAGE 01 <br /> 05f09f2e03 10:28 4640138t ENUZRONMENTAL l-IEAL PAGE 02 <br /> e. .SAN.JOAQUINCOUNTY <br /> ENVIRONMENTAL, HRALTH DEPARTMENT <br /> JUN S 2003 304 EAST WE;I;ER AVENUE,THIRD FLOOR <br /> STOC"ON CA 95202 �. <br /> ,EfUVIRDNME��T N��L��i (209)4M.,U20 <br /> Pfir�•LILLc't—mq re- PUBLIC R�CQRDS RELEASE APPLICATION <br /> APF'LiCANT SUStNIE;s�fACsENCY�. <br /> A_ ADDRESS Ko Crciciu Djausa Croi-c- <br /> PHONE F§ FACS1t9HLf3 _E •2_03— -2-1 <br /> TENTATIVE*AppOINTMENT DATE.__LTIME <br /> ' <br /> (Pieme l9Ive T to TD bustnm'ss days from age of a <br /> �IiCBtK�n mub1r*:ta{j �.�.�• � <br /> CHEtK BOX TO 4c>OrM REQUEST-$89.04 FEE—REQUO T PROMSSED INS SUSIb ESS 1;A` , <br /> SIGNATURE OF APPLICANT _ I✓'= _ DATE <br /> FILE ADDRESS THIS Sl:tE SHD:iTAF•F USE ONLY <br /> _ PR0GIZA14 M :ME�+ITS tOZARCH <br /> C% ! �— <br /> 2 <br /> - � l <br /> h. <br /> ENVIRONIV EWAL I4EALTFI UNISION FILES <br /> ( UNDCROROUND TANK(UST)CLEANUP SATE(LOP) Q HOUSIh 0 ABATEMENT � S01_113 WN iTE I�AGJM Y j <br /> PL OTNER CLEANUP SITE(NON-LOF) O FOOD FACILITY SOL"WAdM VE"j .E ^� <br /> a6c. Ll UNDERGROUND TANK WONITORIMO i MOVAL) C3 DOG IO NNEL CE V)I RY <br /> 9 HAZARDOUS WASTE CMNERATVR Q GIilM.-N RANCH 0 PI;G 7REA HENT PLANT <br /> D TIERED PERMrrfED FACILITY 0 MOTELaHOTEL aD Pt$MiPER-r EZUCICA ARINCHE1wI TCNLET^a <br /> d TAT=1130DYPEIACING R POOLMPA O .U,NG U$15,4PPu1AIT'DN$11'ES ,r <br /> d MEDICAL WPZTE FACILITY 0 OTHER(PLRASE 3PECtt=`fl <br /> 1. List up to ten addresses in the Space above. Select the type(s)of Files from the list a bove.by checking <br /> the appropriate box(es). At least one file typo MUST be selected. lax ttr jzc 49A4_1 38 or mail to the <br /> address indicated.above. <br /> 2. EHO will notify the appllcarit if any FHD files-axlst. An appointment for review wili be co firriedi <br /> approximately tive business days but no lator than telt (10) days after r40i,.tipt of.Ipplication. The flies <br /> will behold for a maximum c f five businezu days for review. AppolntmP.nL•S should be scheduled. <br /> a wardingly. <br /> 3. A fila that Is actively being worked an by lEF•ICI staff may not be immedii--rtely favni'labl-a for review. A now <br /> application may be submitted when the file h;available_ <br /> 4. Any file not returned in the same condition art released will be reorganized by I=HO rAff at the expense <br /> of the applicant. Future file reviews by the same applicant may nequiI* a 589.110 depvsk prior.to review, <br /> 5. *TEN'T'ATIVE appointment dates arnust be can firmed with EHID staff <br /> a. Applications received after 3:00 pm will be prooessed'the next business Clay. <br /> COMM'kM izD Ai�Pat7lNTI�I EN Y'DATE TWE <br /> PATe CONPIRMED IP PONE FAX INITIALS ,;�.......__,� <br /> REVIEWED YES -NO REMEW CTAT <br /> [3lD�6C C <br /> 71r,1C1907 . <br /> r <br /> I <br />