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tai PHONE NO. : 209 369 4220 _ Feb. 09-2000 09:08AM P2 <br /> �. SAN-*"AQUiIV Ol1NTYFUBi1C KALThIE <br /> r.,u Svc H�,uo« <br /> F-NV1R0NM AL HEALTH oIV1'9l0 vtcEs _ �O <br /> 304 BAST WEA AVENUE.THIRp FLOUR <br /> ST acrcN C:A os= <br /> (209)40�3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> ALIDANT��77 <br /> ADDRESS <br /> PHONS + _ <br /> FACM MU G� <br /> TENTATIVE•APP(M EW oATE <br /> iFtgas.give T Io Tt!�usrasss O*Y$from cele <br /> y Opi��tlot+aylr+nitt=I) <br /> C11>CK 00X To EKFa#ptYt!RSQUW-Sta.00 F"-REMM5T pRACEeS€O IN i BLI&WE38 DAYS <br /> SIGNATURE OF APPLICANT <br /> DATE <br /> RU A13ORP331 <br /> Z nu A*A . <br /> WA <br /> r �AoLs <br /> ENWRONMENTAL HEARTH olV(SiON FILES <br /> *UN0BR9$LQUIIb TANK JUST)CLXM UP 3[FE(LW) t3 40USINGASATEMENT C3 ,RDLIPWASTF FAfAUTr <br /> Cy 0'n%4 CLFjWUP east(N0N-L0P) E3 PIDW FrIMMY 0 W�D WAM Vt:MiCLF, <br /> `$ UMMRIGROUM TAMK(etcisr TQFUN*1rn" MAY o WG KEmMM t3 DAIRY <br /> VIZttAZAP*0U$VWA=GMfAA-1MM Q Com)RANCH 0 PKQ TMATMTPLAMT <br /> Tr 'nEREC)PERM TTI M FA=-Y E3 MMLJHOM E3 MWER TRUCMLRC]IGHQt TOIIXM <br /> R 7ATTOOIBODY PSMING Q P+OOLMPA to LAM USE APPUCAMM SITES <br /> [7 MLPIQALWAsM^ACu r y a PUVLUCWA'TER SYST04 Q OTHER(P'LrMV SPECIFY A30VM <br /> i. List Up to ton adctrs"as in the spa"above. Select the type(a)of files frorn the nst above by checkino <br /> the appropriato box(as). At Joei st one Me type MUST be selrected. Eg&t>!1208}4&.0138 arMaUlp he <br /> MMAil&Irrdlr�,ave. <br /> 2. END wilt natgy the applicant if any EHO files exist. An appointment for ravisw wilt be conarmed <br /> bpprox(mateiy five buslrwss days tit no Sitar than ten(101 clays aftor nxmipt of application. T'be tiles <br /> will be hiI for a maximum of fire bu3"ure"days for tOviRW. Appolntnisnts should be scheduled <br /> accordingly_ <br /> 3. A Me that is actively being worked cn try EHQ it4ff ratty not tte lrtartaxfistely avalleble For ravidw. A new <br /> aPPIlratiort may be submitted When the flia is,auaU4bla. <br /> 4. Any fie not returned in tris tomo aanditiun as rrrleaecat wilt be reorgatni f by ZHD staff M the expense <br /> of the 6ppiicarlt. Future fila reviews by the tsme alpMica M may require a$78.00 deposit prior to rovlew. <br /> 5. 'TERTATIVE appolrrb"rit dates must be conflemed with EHO staff. <br /> 6. Applications recahred after&00 pre will bQ PrOCesaed the neXt busineas day. <br /> CONPIRMEb APPOINTMENT CIATE ., �.. .._._ TIMIE <br /> DaIfi;COl1FlRMEt7 PHONE FAX INMALs ; <br /> ! REY{I;YYEt) <br /> YES NO REVIEW DATE <br /> 69 60,. w <br /> TOTAL. P.01 <br />