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09/16/2005 13:30 209472 PAGE 02/02 <br /> � 0 <br /> =WMED 4648138 tM1 <br /> IN SAN JOAQUIN COUNTYPUSL IC HEALTH SERVICES I -Aft <br /> 5 E P 1 6 2005 V ENVIRONMENTAL.HEALTH DIVISION , <br /> 304 EAST WEUER AVENUE,THIRD FLOOR <br /> STOC TON CA 95202 2o2 <br /> ENVIRONMENT IiEALTN (209)4693420 PERtnT/ ERVICEn <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> ' C <br /> ADDRESS � <br /> PNONE FACSIMILE g� <br /> TENTATIVE'IWPO (Pt +7 to 10 busfam d prs appIkaag"sub Kfaq. <br /> CHTEM BOX 1U 6XP rfF_REQUEST'. 89.QQ - ESs <br /> Ct 0 IN 3 0 N Y <br /> SIG URIs OF APPLICANT N WNW <br /> RDA �0 <br /> FILE AMMS THIS SIVE IlNp STAFF USE ANLY <br /> PMMR4M MMAEM SEARCH <br /> LP5 T <br /> V 7� <br /> ENVIRONMENTAL HEALTH OMSION F=ILES . <br /> UNai:RG (N <br /> ROVNO TAtNK(UA CLE-MUP SITE(LOP) A HOUSE A SATEMENT 0 SOLS WASTE RACit Lt <br /> R CLEANUP SITE ,q 460P? 0 FOOD P 0 $AIRY WASTE YENRCt <br /> :UN:IDERGROUND TANK(MON iNGfEtEWNALiO >3 G pK aY <br /> RDYUS WASTE GO-WRATOR O C RANC" ❑ puI TREATMENT PLANT <br /> ❑ YMEO PERIMnTED FAC]Ln Y ❑ m ❑ PUMPER TR MnXATIOM IT Y011 EY5 <br /> ❑ TA PEOtCtt1Q ❑ POOUSPA ® 4.AIiD USE APPI lCA1lQN Serss <br /> Q TATTOOmearAWASTE FAoti.t'e`t' 1 A PUBLIC WATER SYSTEM Q OTMEA it'UWE SPECIFY AGOVEl <br /> I. List up to Leet addresses in UK space above MUST e( thtyPe(selectPd f Fax fro249 m the list above <br /> o e btnach Q kteg <br /> en <br /> the oppmate box(es)- At least one Rte type <br /> ss' a Pi}a Qantmertt for reviow Witt be ssotsfirmed <br /> 2. EHD wiU notify thea licmnt if ally no teeter than ten(10)days after re+�lpt ofi dpptitti4n, The files Ir <br /> apgroxianately five bs�k8ners dayz intsttents should be sGh@doted <br /> will be hefd far a maximum of five business days for rtwiew. Appo . <br /> accordingly, <br /> 3« A file that is actively W-"§Worked on by END stiff may not be immediately ayailatrle for review. Anew <br /> appfiCatlon may be submitted when the file is available. >rHD staff at the expense <br /> 4. Any file not returned in the same condition as relearsad will be morganized by <br /> of the applicant <br /> t. Futut#file reviews by the came applicant may retquit'e a$89.00 deposit prior to ee�►ievn- <br /> , <br /> "TENTATIVE®ppoin".ent debts must be confiteted With END sta <br /> 6ff. <br /> 5. Applications received after 3:00 pm will be Processed the next business day. <br /> CONFIRMEDAPPOINTMENT DATE. Tota <br /> DATE CONFIRMED PHONE FAX •INITiAtS <br /> REVIEWED YES NO f2t:VlEW i7ATE <br /> P <br /> ........................ <br />