Laserfiche WebLink
03--01_�Woo 89:4 t;m F"- ..�+�. <br /> SAN\ ,AQUIN COUNTYPUBLIC HEALTH 56,110ES <br /> ENVIRONMENTAL* DIVISION <br /> 304 EAST WE13ER AVENUE,THIRD FLOOR <br /> $XOCKTON CA snw 1 <br /> (202y 468.3Q0 <br /> PUBLIC RECORDS RELF-ASE APPLICATION <br /> OLPPUCA"'r[[ �f�1 Avti 1Li-��_-. ____--eUSINES51AGEHCY <br /> AODR993 1 k --I- L'm't-. NNVW\ Xqt, S O ,V4_ 6 <br /> >sH4NE Z�°t � --2 ZZ 1 FACStkAtlLIE Z*0 I - 5'?_�- 2s <br /> TENTATIVE'APPOINTMENT DATE lc > '- � I 7' T.E <br /> IP€vasa prV*7 to!0 business dors from stats nr applf Iipn submittal) <br /> * 3 <br /> XK:HECK eCx TO EXPEDITE REQUEST-$wbo fEt-RE��P D ESS40 IN 3 USINESS DAYS <br /> SIGNATURE OF APPLICANT �Ih'� s � DATE <br /> FILE ADORE$$ <br /> 5 L - <br /> 1428 <br /> 5 <br /> E <br /> IFENVIRONMEITAL HEALTH DIVISION FILES <br /> )<1UNDCRGR04N0 TANK(UST)CLEANUP 5tTE-(Lop) 0 HOUSING ANATEMENT a SOLID wASTf FAClOrf <br /> O OTHER UL[ANUP SITE(NON-I.OP) d FOOD FAClL17Y I? SOLM WASTE VENICLF <br /> XW40ERGiROUNDTANK(MDNrrommwaEMOVAL) 0 oaG KENNEL 0 DAIRY <br /> O NAZAR! O$WASTE GENERATOR a CHICKEN RANCH D PKQ TREATMENT PLANT <br /> Q TIERED PERGiiTT6A FACILITY 0 MOTEt1HQTEL Q PUMPER TRUCKIYAgD)CHEM TCtLETS <br /> n TATTOOMMY VE114CiNG O P*Qtf$PA O LAND 1J3E APPLtCA-nON 3IT9S <br /> CI 14EDICAL WASTE FACILITY Ct PUBLIC WINER SYSTEM O OTHER tPLE X SPECIFY AVOW) <br /> ?. List up to ton addresses In the mace above. Select the typo(s) of fII*S from the list above by Checking <br /> the appropriate box(es). At least one flTe type MUST be solected. Fax to 12091 464.11138 Qr rnail.(Q tlt� <br /> addresEs ingficided Qbgvq. <br /> 2- EIiO will notify the applicant if any Flit)files exist. An appointment for review will be confirmed <br /> approximately five business day-s but np later than 16x4(10)days Tlfter receipt of application. The files <br /> will b*hold Tor a maximum of five bUsiness days for review- Appointments should be scheduled <br /> accordingly. <br /> 3. A the that is actively Feeing worked tin by EHD staff may not be immediately avatlable for review. Anew <br /> application may be iubrnitteq when tree file is available. <br /> 4. Any tike not returned in the same condition as released will be reOlyanized by EHU staff at the vkgense <br /> Of the applicant. F;oture lilt reviews by the same Applicant may require a $78.00 etepo$it prior la review. <br /> 5. 'TEHTATIVF,appointment dates must bo confirmod with EHD staff. <br /> 6. Applications ree*ived after 3=pm wslil he procvssed the next business day. <br /> i <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIAIy eo __ PHONE FAX lfi>FiftLS <br /> EYIEWED YES NO REVIEW DATE <br /> TOTAL P.02 <br />