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RPP.-26-2005 08:42 FROM:SECOR - ITY SITE 5592333241 TO:4 .38. _..,\ P.002/002 <br /> 167/14/2084 16:05 2094683433 FIFTH FLOOR <br /> L PAGE 02 <br /> OVLTE RELIVED <br /> 040 LOG NWSL•R <br /> o ,a II��=r �� SAN J OAQi IN Carty <br /> F���L�u`J t, ENS UNMNTAL READ DEPARTMMNT <br /> 304 E Webcr Ave 3'�'Floor SxvcktoD,CA 95205 <br /> A P R 2009(209)468-347,0 Fax: (209)464-D138 Web:www.ro_z3n-joaquin_muF;/Chd <br /> 17R% <br /> ENV{r 0NMIEM HE-A TH rumiC RECORDS RELEASE APPLICATION <br /> P <br /> APPLICANT: <br /> BUSlNEsvAGENCY: <br /> -ADDRESS: <br /> -- <br /> TENTATIVE"APPOINTMENT PA1IE: <br /> (Please allow 10 business days fr m date Of ePPflr460n submittal <br /> DEDITS RE <br /> �nO NATU a LICANTklip <br /> _ <br /> `""" 5 � Use OnN <br /> AP9 gAn <br /> FM ADDRESS uNr r J. <br /> fro lilC P_ F ❑ Unit 1 <br /> U . 2NZo <br /> ��K1zlilST . Usr tirrtt 2 <br /> tt 4z- <br /> e f,it aZ r sina� cat a T Unit 4 <br /> 0 Co l V-L u)ST v Unit 5 <br /> a. <br /> ENvIRONME14TAL HEALTH DEPARTMENT FILES <br /> a� Ca suLID WAS'M FACru y <br /> x+ UNDEAGROMM TANK(L"CI.MUP Sr7F(LOP) A 14OUSiNG JZATEMENT a SM"WASIC VEHtcx� , <br /> 0 ardM CLEANuP srM(NON­LM 12 rWO FAMMY <br /> bf UHA6RGMIM TANK(MON MRfl =r;:1ACVMr) 0 DOO KSNNFJ. G PKG <br /> D YArATMEN'T FLAW <br /> Q HAZARDOUS wA TC dt<NFJtATM C1 cHMKEN RANCH G pUMM TRUCwrARWCNEM TOILETS <br /> 1a TIERED PSRM11 1 FACRITY <br /> P60MPA <br /> L. t/WO USE MPL1t~AI71OK S(TEs <br /> ❑ TATTO=dDXP0D;t NG OTHER(PLF./LSESP£pFY) W .ac3i <br /> 0 MFUtM WASTE FACir J t'Y <br /> ` <br /> 1. List up to ten addrrss¢s In the spaca above. Select the.type(s)of Me$"m 9)e list <br /> fi�-013$-a AY I <br /> 11 chea ckine <br /> the apprapdaW box(es). At bast one fife type MUST ba selected. En <br /> fo(Z0address Indl_Nd a c,ye by appointment for review will be G.OnTirmed <br /> 2. EHD vAlI notify a applicant if a EHD files Mitt M aPP° ays after_ <br /> apP�mat l five <br /> busInes of fir�ie tauslness days for but no later than threYfew�ApPointm s sho Of dpbscheduled <br /> The flies <br /> will be he <br /> accardingly. <br /> 3, A file that Is actively being workdd on by EKD staff may not b4 immediately available for review. nay <br /> Application may be submitted when the file N axanable. <br /> 4, Any file net returned in the same condition as released.arid be reorganLred by END staff alt the expense <br /> of the applicant Future file revlows by the same applicant maY regrtlro o$93, <br /> a0'daposft prior to mvle� <br /> S. Tq appaintmetlt dates must be confirmed with EHo staff. <br /> after 3:00 pm will be Processed tho next business day s <br /> 0. Apprcatlons received '" ., . <br /> t ll"A amu.' :*,r. TIN[L vt.t, 1 r •.,'� y, y_'_.,Jib its",, <br /> lF}HbN . . FAX':_ '•;:M�;'!�.;� 2. <br /> .+ ? =�'' <br /> ': fa REVIEW DAA F - <br /> ' 'V1EV1fEl) f Mtn <br /> 'YES <br /> RAWO0 <br />