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87/15/200$ 10:06/g- 13107W,' , PAGE 01 <br /> I ' <br /> 10/20/2086 14:48 464013$ ENVIROHMIZNTAL HEALTH <br /> , 17 1 Y% , , SAN rAGEw 01 <br /> ()AQUW COUNTY <br /> 304 Fast Weber Avenue,3`d Floor, <br /> 200. SOar,�ton,CA 952{32.2708 <br /> i . 5 8 Trl honf�:(aa )468-342o> x:(20.)46"138 w ar; .a g .�vic <br /> � <br /> PUBLIC RECORDS LEASE APPLICATION <br /> 7 <br /> ,� 6U5ttJF�SIAGEN�v::,���, <br /> AwRE,-4 tea„ Gaiwii a Di aMo, WryIsm _� <br /> PHONE(i):6125^"7!jk— �� �fJ .._ ptfom(2): <br /> TENTATM'Appoiw mwT rim S Time-, <br /> {Please alloy dA b�rslnea�dttyb fr�dna d�tc+of appYlcattan stehtttitlel.RT®rrl�Ltro an1Y�Rxust b�ca�firnietlj <br /> d CHECK BOX To 09P=OrM ES 0_FEE Hi CW$CK GNt.I?^FigOVEST PROCESSED IN 8 Stl81NFt9 OATS <br /> S'ic�NATURE OF APPLICANT DATE :Yf5ilag <br /> I"IAothbnir ItlWrmotion: ©L'st Q Map Dagedply4rt; __- <br /> FILE A013R EHD:USE ONLY <br /> Seraek# street ldenro cHty ❑ urnt i <br /> ,Z. 'JM 112i CO 909 <br /> - - c3Jra. . Un1t <br /> 4. Uri1l d <br /> 7. <br /> ❑ links <br /> on 6 <br /> •l0. <br /> SpecitiG Dab Rings of Information Requerstt M'From <br /> ENVIRONMENTAL X11 .TH DEPARTMENT FILM <br /> AMMUMLM TANK(U5'l)Ct nNW STM(LCP) 13 00Us>!ua AZATF.1 ENT S DFaD WAVM FASB rrf1V0M►= <br /> O E PSM(t OR- oP) .e FaopFAMTr 'Asi'nita - <br /> efo2=�c t*VA1fK Sl�ariMMMWJla OVAL) o DM K6re ML biMY <br /> WASTE +f:P-MEPATOR 13C oCm P-sx.H I�11IWA1�61 TWATR�eH7 P Na' <br /> RM <br /> MEPM W TTFa FACLrT1r ©MOTOAJO Rt. PmPaR7fW**YAw?CM TaleM <br /> WF34aY P19Rt M 13 PDot&PA 0 Lot Uig APPUCAToN SMW,46TCt- <br /> ACM,rrr rClCMfrKIi'LrAMSFMWy) - <br /> WELLANdBEPTIOPs Ic=eoubsARetAVAI[A�t£fDR171�VptN- Hlot�hY 1pEtp',�B:Q4148A•5:t7flt+N ■ F„%CLUDtNfpIiOLH4At5 <br /> 1, List up to tan addressees In rho 6pace obove. gFtfett the"e(o)of Mex from the list ubwm by dttf7l*Ma the appr"fta � <br /> box(es). At least ono File typo MMI"be selefstad. F A I to eb Address <br /> ranEeavArl not be accepted for-addltlanW assiatance vAth irds addrs s,t*Afaet the EHI].AppllbaUbng tezelved atter <br /> .2,00 pm will be proamed the nart 8tasin*s5 day. <br /> 2. 91ta r:KD wiq lfaotify the applicant if any 119D filos exist. An appalMment for review will bo 0onfimied eppr4xtrii�steSy bar+(f� <br /> trays after facalpt Of appltbafion. The 11162 Will by held fora rnUlrnum of flora business dayc for MAQw. Appoitntmetets <br /> ohoald he schodulad MeaHAR91y. <br /> H, A file that 1s actively being worked on by END S'ff may not be Immediately availAble fer reu3ew. A now applIcatlon may be <br /> .aubtHdtted when the file Is available. 'F <br /> 4. Any file not reWrnad in the Mame 6ofnditian as raiaaled will be fgargamtzed by MW staff at the e7gyense of the apptlearvL <br /> Futum file reviews by the sans applicant may squire a$95.40 deposit pflor to revleW.,, <br /> E140 USE'ONLY <br />