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—, �0_et •2.8•_;2003 5:3.9PM 1 0• Anderson & Assoc• No•3395 H,P• 2 <br /> SAN :.—AQUIN COU NTYPUBLIC•HEALTH SE"CES <br /> 0 T 2 8 2003 ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> -"N';( _,r�jV;�f`+i i;FACT H STOCtCTON CA 95202 <br /> ='F= ;",1!ii;f R'f1Ct S (209)4a84U0 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT C kN' VVr_\ SUSiNSWAGENCY_ <br /> ADDRESSa -^-�rToU--s7�o:� LOG k <br /> 2- ( <br /> PHONE 0 '31f� l -� /b FACSIMILE <br /> TENTATIVIE"APPOINTMENT DATE NOV- 10- 0,r, ' nmF 001 am <br /> (Plaase give 7 to 10 business da from date of application submittal) o <br /> 9 <br /> CHECK BOX TO EXPEDiTE REQUEST• oVRE PROCESSED IN 3 BUSINESS DAYS /� ) <br /> SIGNATURE OF APPLICANT DATE Z7 Z 03 'T GLS <br /> FILE ADDRESS /��� � c` Q THIS SIZE EHO STAFF USE ONLY <br /> M t I S PROGRAM! EN TS SEARCH <br /> r 3S 75773077 - <br /> S• 3 r a., <br /> S1W, 1 + <br /> 1673 W. t <br /> W s <br /> +7 <br /> ENVIRONMENTAL HEALTH DMSiON FILES <br /> �ERGROUND TANK(UST)CLEANUP SITE(LOP) O HOUSINS ABATEMENT ' O SOLID WASTE FACILITY <br /> �ER CLEANUP GITE(NOX-LOP) ❑ FOOD FACRny O SOLID WASTE VEHICLE <br /> HEROROUND TANK(MONITORiNGIREMOVAL) ❑ DOG KENNEL O DAiRY <br /> AZARDOUS WASTE GENERATOR 13 CHICKEN RANCH O PK0 TREATMENt*PLJ► , <br /> ❑ TIERED PIERMrTTED FACILITY O MOTEL/HOTEL a PUMPER TRUCKfYARD=EM TOILETS <br /> O TATrowsoDY PEIRCiNG C] POOL/SPA (3 LAND USE APPLICATION SRES <br /> O MEDICAL WASTE FACILITY CI PUBLIC WATER SYSTEM D OTHER(PLEASE SPECIFY-ABOVE) <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking <br /> the appropriate box(es). At least one file typo MUST be seloetod, Fax to-(2091484-0138 or mall to the <br /> e <br /> address,indicatog above. <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 ton(10)days after nneeipt of application: The files <br /> will be held for a maximum of fire-business days for review. Appointments should be scheduled <br /> accordingly. <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 tho file is available. <br /> 4. Any file not returned in the Same condition as released will be reorganized by EHD staff at the expenso. <br /> of the applicant. Future file reviews by the some applicant may require a$88.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br />