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Received Feta -02-01 08:49am fres CCITT G3 i PIERS Env!ental page <br />02-02- IZ 08'-SeRM FRGI•� TO 14095360294 P. 0-1 <br />waa L JCtI'aNty W W 44tr++U,tULlt <br />z f©-1 r17) SAN .iOAQUIN COUNTYPUBLIC HEART' SERVICES <br />C ! P-NVIRONMENTAL. HEA I.TM DIVISION tp 7.3 <br />30.4 EAST WESFR AVENUE, THIRD FLOOR <br />STOt KION CA 93202 <br />(209) 460-3420 <br />i PUBLIC RECORDS RELEASE APPLICATION <br />APPUCRNT VlrCJt,f moi•00ttA''r <br />PxoNE <br />40%, U FFtCSIhiiLE Ao �Otlw q4 <br />T ENTATIVE' APPQ1Wrr4EIiT DATE A• �JA f,. ` TSfvIR <br />(P1■ara QW4 7 tq 19 Eualr.0as da�ramtBald of t ppilcatlan aubintUll <br />D CXZCA 00'A TA EXPI»tlrrE REQUEST t 9 ?/-REQUEST PRO (3320 IN 9 BU31NE33 DAYS <br />SIGNATURE OF APPLICANT <br />is iVIRONMENTAL HEALTH DIVISION FILES C-y�,S �to+� <br />UNQERGFOatj2�D TANK tUST) CLEANUP SITE (LOQ') C) HOUSIN13 ABATEMENT 13 -OUP WASTE FACILITY <br />OTHER CLEANUP SITE (MON-LOP) 0 FOOD FACIVTY C1 SC ILID (WASTE VrHIC" ON St's <br />UNDP.A0ACUlet? TANK(M0XITQRlstt's 9CM0YAL) m 000 KENNEL Ln DAIRY <br />KAZARDOUS WASTE! GENERATOR ❑ CHICKEN RANCH ® PKG TREATMENT PLANT <br />Ca TIfiREo PERMMr-D PACILrr7 CZ A1tMLJH0TEL 0 PUMPERTRUGWYARDICHam 701LETs <br />Q TATT=aQQT KIRCING. II l 600SPA " " t] LAN13 USE APPLICATION SITES <br />0 MPOICiALWASTE FA.[iL,ii'Y Q PUBLICNVATliRSYSTEM OTHER (PLdAp E3PECIFYAPOVE)- <br />1. List up to ter, addresJsod in the space above, Select the type(s) of files from the list above by ChoCltfng <br />the appropriate box(es). At (east one fila typo MUST be selected. Fax to f209) or mall (q the <br />ddress irrilioated above. <br />2. EHD will notify the appllCant If tiny END files exlSt. An appoIntmertt for review will be confirmed <br />approximately five business day3 but no Inter than ten (10) clays after rooelpt of application. -Tile files <br />will be held for a maximum of five business clays for review, Appointments should be schedulod <br />arcardingiy. <br />3. A fila that is actively being worked an by E140 staff may not ba immodiatgly available for inview. A n9w <br />appiicatbn may be O"brniUad when the life is available, <br />A. Any filo not returned In 41% Sarno condition ma released will be morganiz04 by END staff at the expense <br />of the applicant. Futitra file reviews by thq same appllaartt may require a $97.00 deposit prlor to rev%W, <br />5. `TENTATIVE appoIntmoni Ctatea rnuat be conftnned with "o start. <br />5. AppiiCations received after 3:00 prn will be proc®ased the next busIness day, <br />CONFIRMED APP€)INTMPt+1T DATE TIME <br />DATE CONFIRMED PHONE FAX INIT A43 <br />REVIEWED YES NO REVIEW DATE <br />TWFL P.01 <br />