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FROM FAX NO. ]'rr'i. 05 2303 08:20AM F2 <br /> 12-19-2000 0911BFY1 FROM TO _� 162FW54347 P.02 �4 <br /> u1lTE uacunac _ <br /> �I <br /> rel ` mac �'jSAN JOAQUIN COUNTYPUBLIC HEALTH SERVPCE`i\'/ �- I ENVIRONMENTAL HEAI..TH DIVISION <br /> ' 304 FAST WEBER AVENUE,THIRD FLOOR <br /> JUN 0 5 2003 STOCK03N CA 95202 ��`'�'� <br /> (209) "8342D \ J 11 <br /> NV6UNMENT HEAL -PUBLIC RECORDS RELEASE APPLICATu01�``"—`—� <br /> r / <br /> APPLICANT O RUSWessu EOENcy <br /> PHONE �77 <br /> TENTATIVE*Appom MENTOva ___._ mug <br /> (PleaSegMe7to�06wln�ssdmyofrmttdabotaPPlicatlonst�iltt:�}' '__ '"�'� <br /> C3 CHECK BOX TO EXPEOME REQUEST-Bar.DO FES--RfigUEVI'PROCMZDJN30WWMSDAY3; <br /> SIGNATURE OF APPLICANT DA"E <br /> FILE ADDRESS TH($REti.'�I:HD:ETRJPi=iBF <br /> PR mkill ELE111:1fT$a <br /> 17 <br /> 400 -- <br /> ENVIRONMENTAL NEALTH DIVISION FU..ES <br /> aaa. <br /> UNDPRGROUND TANK(UST)CLEMUP SITE CLOP) ❑ M=IN D ABATEMENT �SOLE:)•WA:rrE:FACI[.IrY w <br /> OTHER CLEANUP SITE(NON-LAP) ❑ FOOD FAC0.JTY O SOU11.WW'"Ti F:MICl.6 <br /> UNDERGROUND TANK(MONITORINGAt8MOVAla 0 DOG KP,NNEL O DI11RT <br /> HAZARDOUS WASTE GENERATOR ❑ GlaCKE:N RANCH O P1:6'DiEA YMtI;EpII:PL%NT <br /> TIERED PERMITTED FACa.1TY 0 MOTIlJNOiEL �}PUIID'FA.'1 RUCIVIARD/CHEl1 TDII.ETTi: <br /> fl TATrOODOOY PEMCING 0 POOMPA -'• LJ,Wl USE APINJUATION SITES <br /> MEDICAL WASTE FACILITY 0 PUBLIC WATER SYSTEM D O',i HEiR(FI.EA;IL:iPE�FYAEIO�IE] <br /> 1. List up to tan addresses in the space above. Select the type(%)of files ln:ill 0 to llst above by chi ln(1 <br /> the appropriate box(es). At least one file type r MUST be selected. Fax 11i( )�4iF!(J}] t, or njto t17g1 <br /> addre-"indicated above <br /> 2- EMD will notify the applicant If any END files mist An appointmerit for reeled 11rL41 119)CDnfinned <br /> approximately five business days but no late:•than tort(i0)days altar rluc:ypt a4 DIr pLteaMon. The fllrr:s <br /> will be held for a rnwimum Of five business days for review. Appointin,mits sl Ieuild be uchecluted <br /> accordingly. <br /> 3. A file that is actively being worked on by EHI:I all may not be ImrnedlaWly avallnh'le for revlew. Anew <br /> application may be sublil when the file is available. <br /> 4. Any file not returned in the Same condition a!E released WW be rMVanl.:e J bar,Fi;ND:(taut at via expense <br /> of the applicant Future file reviews by Vjs s:!rn*applicant may squire a MJ f0(lr>pfrAt pricer to revflnlr. <br /> 5 'TENTATIVE appointment date:must be eon Irmed With EHO staff. <br /> 6. Applications receives atter 3!00 pm will be pr,oaessed the mart bul0neau(lay. <br /> CONFIRMED APMINT MENT DATE TIME <br /> D`aTECONFIRMED PHONE FAX <br />