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RM : GLOBAL ENVIRONMENT" AND ENGIN FAX NO. : 16267320489 Nov. 03 2004 12:09AM P1 <br /> lY�,+e� eUy)-i .i:2ENVJ.NUN?,>L,tALIY <br /> (p,a t6�PECCIvf e(��l SAN JOAQUIN COUNT <br /> CCCC C� ' ENMONIMCNTAL HEALTH '�EI'�T. 41 <br /> 394 H Weber Ave 3 Floor Stockton,CA 2 . <br /> NOV 0 2 Z004 (209)468-341-CIO Fax, (209)464-0138 Web: w•ww.cv. ca vs/ehd <br /> EWRONNIENI HEALTH PUBLIC RECORDS RELEASE A ICAATION <br /> 4PFL)CANWT! � »��4 - BusmissrAe3p!ICYc <br /> A 1 U <br /> �r (d� FACSiMI E' F^tt <br /> NON&: ��b <br /> -6114 L cel 1 <br /> -'ENTATP/E"APrQ1NTMEiJT QAT!": <br /> (Ple,sa stlow 10 inu2tli,*4a days from dote et app)i=Van submntal) <br /> T~ CHECK 00X TO EXPSAtTE REQUEST•S33.60 FEE.-REQUEST PROCE53ED IN 1 ZUSINF8,�DAYS <br /> SIGNATURE OF AFPUC;ANT DATE <br /> rD8p9f;fnant use Only <br /> UNrr <br /> >=IL.E,an�bitCss <br /> Unit 1 <br /> 2. are., 0 Unit 2 <br /> a. 8a:a1 <br /> e.• Unit4 <br /> r� <br /> Unit 5 <br /> - <br /> GN � <br /> ENViR0Nb1ENTAL HEALTH QEPARTMENT FILES t;" <br /> r z•i '' � " <br /> CLEANUP SITE(LOA) 6 HOUVIO ABATEM'EEYT C7 SOLED WASTE FACILITY <br /> UNDERGROUND TANK(UST) U SOLiD WASTE VEHICLE <br /> 0 OnER CLEANUP SITE(NON-J-OA) la FOG ENHE TY C3 DAIRY <br /> UNDERGROUND TANK(MONiTORjHG1REM'0VA!) 0 cHi KEN RA � pK0 YRzATM ENT PLANT <br /> H,47Af2D'0115 V+iF�STE i3ENERATQR <br /> G CNiCKEN RAHOFa a pUMIpt:R TiZUCKIYARDICHEM TO{LErS <br /> pTl£r2gD pERLA(ITED pAC1Lf7 Y n P007EVii0T L ❑ LANV USH APPLICATION SI-MS <br /> 0 TATTOOIAODY pIFRCINO d OTKFR(PLHA$°SPECIFY) <br /> O FA3Dj0ALWAST9 FACILITY eCkln <br /> q, List up to ten addroD89s in the apaa®above, 591®Ct itte types)of files from tla0 list above!zY ah g <br /> p riate box(es). At least ona file tYp�MUST be aeiactpd• Festa{2Q9 ,{�4.Od38 or ftlaJl to thg <br /> the sp}nr }� <br /> e confleMed <br /> address a tt Ve' <br /> g, AHD Will notify thb 01ppiIcant if arty F-HO fil>aa exist- An appointment for review will <br /> bl,ca>1lon The file <br /> approximately five business days but n0 later than ttn(10)days rafter Tec®ipt of spp <br /> ap be imahoifor a maximum o¢five business days for.reviQW. .Appointrnents should be schedutad <br /> accordingly. woricad on by END staff may not be immodlat9ty available for review. A new <br /> a, A fii©that is activ3'ry being ertSd <br /> applica#ion msty be!auisrttitted when tha fli©is aviniiabW <br /> 4• Any title not returned in the amt)eondttion a*raleesed will be reorganixOd by EHQ stalff at th(N exp <br /> 0f the applicant, Futuro filo reviews by tha same app <br /> 1lcant May require a$9 .00 daposit prior to TOvlew_ <br /> th <br /> 5, ``"F CKTATIVE appointment dated mm w1111 be Mcea odbe ewfirm edlthe next <br /> t b aindss day. <br /> 6. Applications reCtived after 3.00 p <br /> CONFiRMED APPOINTMENT 6ATiE pHdNFDATE rC)NFIRMED FAX dssrrt�.t.s <br /> i YES NO REVIEW p,q7 c <br /> `_�tl=VI1~NTEb ~T <br />