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I \ <br /> Dec-10-04 14:35 From-TTI TETRA T° Ml EINC +9168520307 T-568 P.01/01 F-945 <br /> SAN JOAQUI�LICOUNTV <br /> NVIRONMENTAI.H1✓ATII DEPART NT <br /> i} l; 304 E Weber Ave 3rd Floa tock`ton,CA 952 5 <br /> =<t� (209)4118-3420 Fax:(209)464-0138 Web:www.co.sm-joaquia.ca.us/ehd <br /> 10 2004 PUBLIC RECORDS RIELEASE APPLICATION <br /> AP N'G,'�t= NFSSIAGENCY: �Z? <br /> ap � 1 J NtV ISI E �P-1 Te S' CA 2 <br /> PHONE: 2 ^� 2 FACSIMILE- 3 <br /> TENTATIVE"APPOINTMENT DATE:_"WL 9,3 o TIMM. <br /> (Please allow 10 nasirress days froth dale of application oubty irtal) <br /> CHECK SOX TO EXPEDITE REQUEST-$43.40 FEF-REQUEST PROCESSED IN 3 RUSINFSS PAYS <br /> SIGNATURE OF APPI-ICANTDATE <br /> 41 Dep4iVwnt Use Only <br /> FILE ADDIRESS UNIT <br /> NST t}w 1 y r 7 7 7 c �--1 <br /> STD t--1 unit 1 <br /> 2 S. c <br /> �►4.s i"t� s s. l2A ?-j CAUG ki [� Unit 2 <br /> XPWI, CA9Leme*lir <br /> HW s suet " C t; c unit 3 <br /> 'JS' 6 4aaec 2-3SST t <br /> Nom! b£ W1 c it 4 <br /> NiF 8s 1� s cl% p <br /> Elul s suaer - ` c S lm C� 5 <br /> IV �'J1 5 10 S,MjK �. �1,. i1 c S <br /> 30 <br /> ENVIRONMENTAL.HMTH DEPARTMENT FIs_ S <br /> UNPERGROUND TANK(UST)Ci-EANUP SITE(LOP) M HOUSING ABATEMENT (D 00 WASTE FACILITY <br /> jk OTHF-R CLEANUP SITE(NON-I.OP) O FOOD FACILITY M t.tD WASTE VEHICLE <br /> � UNDERGROUND TANK(MONITORING/REMOVAL) C1 DOG KENNEL C7 IRY <br /> HAZARDOUS WASTE GENERATOR M CHICKEN RANCH C3 G TRFATMI=NT PLANT <br /> CI TIERED PERMITTED FACILITY n MOTFEWHOTFI. Cl MPFR TRUCWYARDICHF-M TOILETS <br /> • TATTOO113ODY PIERCING C POQIISPA 1 D USE APPLICATION SITES <br /> • MEDICAL"WASTE FACILITY Q OTHER(PLEASE SPECIFY) <br /> 1. List up to ten addresses in the space above. Select the typeta)of fit from the list above by checkinL <br /> the apprapriate box(es). At least one file type MUST be selected. Lax .to 1.2091464-0138 or mail to the <br /> aqgrq-!isj1jdjMed a ave. <br /> 2. EHD will notify the applicant if any E"D files exist. An appointment fo review will be confirmed <br /> approximataly five business days but no later than ten(10)days after eipt of application. The files <br /> will be held for a maximum of five bu$Lne"days for review. Appoint( ents should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by F-HD staff may not be immed ately available for review. A ne <br /> application may be submitted when the file is available. <br /> 4. Any file not returned in the same condition a$released will be reorga !zed by EHD staff at the Owens <br /> of the applicant. Future file reviews by the same applicant may requir a$93.00 deposit prior to reviu <br /> a. "TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRIII W APPOINTMENT PATI: TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIMP YES NO REVIEW DATI <br /> to 441-=-00 <br />