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—`--`10/13/2002 23.37 170787 ANTON GEOLOGI P E 02/02 <br /> lu <br /> !. r YPUBLIC HEALTH'SERVICES <br /> E TAL HEALTH DIVISION <br /> dk arm <br /> 4 EAST VV513ER AVENUE,THIRD FL.00R <br /> 0STOCI<'TON CA 95ZO2 <br /> i (203)468-34Z0 <br /> i PUBLIC RECORDS RELEASE APPLIC,ATIO <br /> EIV N7a ( �� �_, E !'i I LSI <br /> APPLICANT• BU31NtSS/AGENCY AnrA <br /> ADpFEs `is D �yX 7c� I�L4C; 5qs Z 0L, 4 2002 <br /> 7b�f • FACSJM1L1:�J-7— -77 �Z7G—PHONE ��� 3Z 1 —tnnivlrrrrrlr�n�e r r, <br /> TF_NTATIVE"APPO(NTMI,=NY.oATI' �P✓2 17, ?,ooz TIME ter;oo/'E MIT/SERVICES <br /> ! (Pleaso` 7'to 1n as Ila s n da applioa n aubintlLnl) <br /> CNIkCK DOX TO CXPF-DITE REQUEST-P C S amus ESS DAYS <br /> SIGNATURE OFA PLICANT DATE <br /> � KILL=ADDRETSS <br /> "THIS Slot CHC+sTAFF USG ONLY <br /> PIZOOKAM ELEMENTS$CARCH <br /> 2163 ; - ,ate <br /> 21 <br /> 2zlo I Qvv+�`t + '-,,1 <br /> 2 f7'51 Cw r3 -j 70^j �► - <br /> e <br /> i <br /> i <br /> ENVIRONMENTAL MEALTH DIVISION FILES <br /> UNOC{RGftOUIgD TANK(U.ST)CLEANUP riTr_(LOP) 0 HOUSING ABATEMENT 0 SOLID WASTE FACILITY <br /> OTHEA CLEANUP 9179(NON-LOP) ❑ p000 FACILITY Q 30LID WASTE VEHICLE <br /> UND GROUND TANK(1401,11TORINGKIEMOVAL) O DOG KENNEL ❑ DAIRY <br /> b(AZA{12POUs VYAS rE G1:NtfiRseTOR O CHICKEN ftAIVCIi 0 PKG TREATMENT PLANY <br /> f <br /> T16Rt A PetRMtTTFD PhCILITY 0 MOTEL/MbTt:L 0 PUMPERTRUCWY••ARD/CHEMTOILETS <br /> O TATCQOIBODY PWRCING O PCOIJSPA "` ® LAND USB APPL16ATION SM--S <br /> O MHDNCAL WASTI;FACALITY D PUBLIC WATER$YSXCM 0 OTHER(FUEA$4 SPCCIFY AUOVQ <br /> I . <br /> 1. List up to tin addrassos in tho$Paco above. Solect the type(s) of files from the list Above by Checking <br /> the appropriate box(es). At least one fits type MUST be selected. Eax to (2091464.01U or mail tgjhC <br /> addr ss indicg_ted above. <br /> 2; i END will notify the appllcAnt if any EHD files exist. An appointment for review will be confirmed <br /> approximately five busine•$s.days bUt no later than tan (10) days after receipt of application.-The files <br /> will be held'for a maxlmurrl of five business days for review. Appointments should be scheduled <br /> j accordingly. <br /> 3.• A fila that is activoiy bain>a*worked on by EHD staff may not be immediately available for review- A new <br /> application Vinay be rubrhiMcd when the filo Is available. <br /> a. Any fllc'not:rcturned in tho same condition Its roleasod will bo roorganizad by END Staff at tits exponso <br /> of the applicant,- Futuro file reviews by the same applicant may require a$07.00 deposit prior to raviow, <br /> 5. ; 'TENTATIVE appointment dat¢S must be confirmed with EHD staff. <br /> 6; 1 Applications rececvad aftet 3:00 pm will be processed the next business day. <br /> r <br /> CONFIIRMED APP0INTMENT DATE TIME <br /> DATE CONFIRMED PHONE PAX INITfALS <br /> R�WIi~Vt)ED dr YES NO REVIEW r)ATF TOTRL P.01 <br /> i <br />