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V bDQ -W'40):91 FRID I u 1. U i i aUJi . r. <br />OtTc RECE"+Ga�SH�L� <br />SAN Jv.:QlJ1N COUNTYPUBLIC HEALTH $El.d IBES <br />i ENVIRONMENTAL HEALTH DIVISION <br />304 EAST S BER A K NU ,THIRD F�-OOR JUN 2 6 2000 U <br />5202 <br />(209) 465-3420 ENVIRONMENT HEgLTH <br />PUBLIC RECORDS RELEASE APPA71QN P��3Jl �1���1, E _ <br />iRPLICANT C.� 1[�L��� UU51fVESS1AGENGY & 5 � � <br />ooRt ss3�D -�� <br />� <br />M I1q <br />fJ` �) rACSIMILk <br />I ?n, <br />TENTATIVE' APPOINTMENT DATE TIME <br />(Pl<-_ a give 7 to 117 business days from data of application submittal) <br />i <br />CHICK SOX TO ExPEDiTE RE r>_s Oo 5E - REQ 5Y PRDCE5SE0 IN 3 BU5INE•SS BAYS <br />SIGNATURE OF APf'LiCANT DATE O <br />� 3�v <br />PILE ADDRE3S THIS SIDE EHO STAFF USE ONLY �/� <br />PROGRAM ELEMENTS SEARCH 3301 <br />Fin— <br />-P3 <br />ENVIRONMENTAL HEALTH DIVISIONF�IU LSLS U L,L U <br />UNDERGPOUND TANK (UST) CLEANUP SITZ -(LOP) ❑ ti0u5)WG AaATEMENT � SQUD WASTE FAGILTTYL _ / <br />OTHER CLEANUP SITE (NON -LOP) C FOOD FACILITY SOU13 WASTE VEHICLE <br />UNDERGROUND TANK (MONITORINGfREMOVAL) Q OQG KENNEL ❑ DAIRY <br />PAZARUOUS WA5TE GZWRATOR O CHICKEN RANCH O PKG 7REATUENT PLANY <br />711 Ri=b PER111ITTFU FACILITY C MOTEI.JHOTEL 0 PUMPER TRUCKJYAROICHEM TOILETS <br />TATTQO/apDY P±_IRCING 0 P53L)SPA A LANG USE APPLiCATTON SrTES <br />MEDICAL WASTE FACILLTY 4yj PUBLIC wa T ETT SY5nN1 0 OTHER (PLEASE SPECIFY A$OVE�) <br />1. List up to ten addre;,Ses in the space above. Select the types) of files from the list above by checking <br />�Iq type MUST be s©lacted. Fa o 209 4B4.01 t8 or mai) to the <br />wo-, files exist. An appointment for review will be confirmed <br />)oto later than ten (10) days after receipt of application. The fires <br />a akd�uy (p-°--- ;Hess days for review. Appointments should 8e scheduled <br />by <br />fi HD tai ably. riot be immediately avaiiabre fcpr review. Anew <br />ition as released will be reorganized by EHD staff at the expense <br />the same applicant may require a $78.00 deposit prior to review, <br />o confirmed with EHD staff. <br />I be processed the next business day. <br />TIME <br />�iIM1I)✓ <br />FAX INITIAJ-S _ <br />_ REVILW DATE <br />1 <br />a <br />> 1 7nTw_ P_0 <br />