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I LL Nay 61 " UU (-t)4 No .L102 P .EJ1 <br /> h{yl{UCL:vGU . <br /> Imo . o v s9_r ,. AQUIN COUNTYPUBLIC HEALTH <br /> ref L,� ENVIRONMENTAL HEALTH DIVISION � <br /> W4 1;AUT WCURAYE,NUE,THIRD FLOOR <br /> { PUBLIC RECORDS RELEASE APPLICATION <br /> appucar�Y�,�.�.,��lfit!�SII _�.�: �cLraira��►a�cr� -- ... <br /> AfDORES$ <br /> •PHOHe E-ADERULE J f <br /> TENTATIVE'AP8o1NTMEmT RATS ME � <br /> fPIMO DIV*7 try 10 bUMMMS do*tram d&W al applicadah submlttl <br /> CI ICOK PDX TO CXPt:bjy: FCr-RCQUCOT PROCLauCD IN 9 O1,i"Gor,DAYS <br /> SIGNATURE OF APPLICANT � /Vt7 DATIE <br /> �- <br /> FI T <br /> Sfbff END 8 APM use OI+tL.Y <br /> 3Cj�� t f►^T 4 _ 'li�likA11L EE.E `iflT$ <br /> k 3 3 <br /> # , , <br /> 0 <br /> ' 1 <br /> a <br /> ENVIRONMENTAL.HEAL7+l Divt8joN FiLES <br /> m ,1U,HV ftQftOtMV TANK(USTI GLEANUP SITE(LOP) d HOUSING ARATEMENF C3 $DEEP WASTI=FAVUTY <br /> O QTIIEEit CL,EAmup orrz(NOR-LOP) 13 F=FACIL1rf O 3MM wASiE VFIt1CLE <br /> W,. mDERGROIINBTANK(MOAIITOR1NVj%jlM0VAQ In E}GGtMNFL Q VARY <br /> V'MAZMDOUS WA370 O RATW O CMICKIN RAMCN a Pio TREATMW PUNT <br /> MRW PdAmirr:*a FACa.nr ., M Komi net G RuNP0#t TRIJG}G rAmxr-nmTosLeix <br /> G TATTOOfBOt Y PEIRGE I S G P00LIaRA IZ I;my use APPMAnoN mm � <br /> O <br /> MEDICAL WASTE FACUTY Q PUBLIC WATER RYSTIFg1 It aMER(PLEASE SPFaFV ABOW) <br /> 1. List up to ton addresses In the sp&C411b1>'vw Saieat the tyM4)cf fifes from tate llat above by chec jna <br /> the Appropriats hox(a$), At least one file type MU3T be selected. Fax to(&Qj)464,0131 gr mail 191 the <br /> address 11jairrated amore. <br /> :2. Elim will notify the appllCAAt if any END fiigo 9XIst. An appointrrterlt far mview wi-abE1 confirmed <br /> approximately five business days but no later then tori(10)days atter receipt of 410plicsi ion. The flies <br /> will be h@td for a maximum otvve business Days forrevlew. Appointmenta should be sEateduled <br /> accordingly. <br /> 3, A Tile that Is actively being worked an by Etta atrlff may not be ImmodloeIy avauawe fat review. A nese <br /> application may be submitted when the the Is avallalje. <br /> +4. Any I11e not returned in the same rorlMan as reltrssed will be reorganised by EHEC staff at the expanse <br /> of the applWmot. Future ilia'mviews by the Beene 41ppiftod maV receulto a$11.00 deposit prior to nrA&W, <br /> *TENTATIVE appointment dates must be,confirmed with EHD staff. <br /> Appilcations received after 3:00 pm win be pro"badd the next business day. <br /> CONFIRMED APPOINTMENT PATI: TIME <br /> DATE CONFIRM£E:y PHONE FAX WrtAt.B <br /> EtEYlEWED YES NO REVIEW DATE <br /> TOTAL P.01 <br /> 4 <br />