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07/15/2008 10:06 131079 '* PAGE 01 <br /> 10/20/2006 14:49 4640130 ENVIR01�9ENTAL HEALTH PAGE 01. <br /> SAN JOA.QU N COUNTY <br /> ENVI ONMENTAL W+ALTH DEV RTM ENT <br /> 4.. •, `- 304 East Weber Avenue,3`d Floor,Stooktoi3,CA 95242-2708 <br /> 008 <br /> Telephone:(209)468-3420 Fax (2Q9)464 Q13$R�eb;www.sjgt�v.Ouve <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> rx.Ic,ANT: lit; C►ar.Ha�st / Bueslrlr=;�srA �flr: A �(�,CeancFf�tl <br /> ADDRESS h n (f'Litm I VtI9 nI d L1�d ?�}I/1)kiit t./► � !�4 �� — <br /> PHONE(1):976-17 L�YJ�°P - P140HE(2): <br /> TENTATM*APPO]W rk� DATA; A <br /> (Please aliarr 1b buslneas days from date of appflaatlan submitlel-"Tarrfab'YQ only-rRtts4 be corfrlrtned) <br /> CHECK BOX TO Mttyr1E MEST19 S9 0 FEE GASH CHECK ONLY)-INQUEST PROCCSSED IN 9 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT (7A1C1: <br /> Etactronic information; [3List❑Map—Daseriptian: <br /> FILE,ADDRESS EHD USE ONLY <br /> gy�gt# Stra4t 1Jxrie City ❑ tlrtlt i <br /> �. I DoVol 1 1 '-'_ i unit z <br /> 3. <br /> Un1t 3 �V <br /> 4. J <br /> 4 <br /> 5, Jnit4 <br /> ti. <br /> 7. Cl Untt 5 <br /> 8. <br /> 9. Unit 6 <br /> 10. <br /> Sper-iflG Dote Range of Inforrnatlon P&quest,ad;From _ GI�' — to <br /> ENVIRONMENTAL H .,TH 00ART' ERT FILM <br /> NnERA uRb TAA(USI)GLEAM P SM(LOP) ❑HQU51E'1G ABATEMENTSol rD WA.a'IE FAcnmNFMW'4 k t) <br /> AZMO <br /> fT�X=M <br /> MER CLEANUP am(NON-Lop) a Foop FAcruTy WAST>?liRa � <br /> tmMMDUHD TANK(MDN[r0RRb11t MOVAt) 17 DOC KERNEL I)AIRY <br /> pUS WASTE GENEPAroR 17 GTnCKUN RANCH A57MATM TREATFFXI l�tAKT <br /> PE�TFD FACturr ©MDTFUHOrt L PVMPaR7RU*gyxWnN=Tbftr 9TATYi30lE�DDY PIflRdNC 17 PDOLISPA d 1_0t)U50 APPLiG4TPDN 61T6E: <br /> WELL AND tffMo f%FNrrFtEC4k0s AAC AWAILAOLIw FDR R=FW- M0MAy1FIVDXe B;00 AM-S!00M • FXCLUMO HOLMAYI <br /> 1. List up to ton addresses In fho space above. &Ieot the types)of f111ax from the list abova by efiacking the appropriate <br /> bax(es). At least one fire type MUST be selecly d. Fax to fZ )a64�Uf or pl, ndrioatod ablomim, Addruss <br /> ranges Mir not be accepted—tor addlUanal assistance♦Mill file addmgse•5,r:onfact the END.Appitoatlons received atter <br /> 3;00 prn will be pronessad the next busints5 day. <br /> 2. The EKD witl notify the applicant if any Efip filon exist. An appointment for review will ba confirmed itpprWmetely tan(10) <br /> days after racelpt Of appllt:atlot►• The flips will he held for n ma ximurn of f%nj business days far review. Appointments <br /> should be sohoduled accordingly. <br /> 3, A file that is actively being worked an bV M)staff may no b9 immediately avallablo for review. A new application may be <br /> mubmitted when the file is available. �' <br /> 4. Any file not returned In the same condition as rale&sed will be reorganized by Eti17 staff at the e5gyan5e of the applicant <br /> Future file reviews by the sartt9 applicant may require R$95.00 deposit prior to review-, <br /> EMM USE ONLY <br /> arm vR <br />