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- Dec 151 03 L224p occ& knowledge P• 2 v . i t rtyLll rkALioTH <br /> SEROrs t <br /> v In I <br /> I' ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> 5rOCKTOrry CA 95201 <br /> �)EC 1 S (209) 468.3420 <br /> PUB RECORDS RELEASE APPLICATION <br /> APP <br /> — OUSINP-551AGENCY UCcv C{ Uf�q /l fJG?W Qac <br /> �.,�AOOItCSS .i1 Q C)r v� � <br /> •PmoNt: <br /> -��.I��.�._. FAc'SIMILC .. �� ✓ � o <br /> TCN1'ATIVC*APPOINThtt;NT OAT, _ TIME T <br /> IPloaw bu. Inq%. dare fio.0 u.,t,w of np�neanon sNb.w Unq <br /> CHECK OOx TO eXP40ITE RCOUC T .$01.0 FEC ,E EST PROCCSSEO IN J 6VSINCSS DAYS <br /> k SIC;NATURE OF APPLICANT � - -, - GATE <br /> c�LE noouC5g THIS slo: EMO STAFF USr TONI C Y <br /> PROGRAM ELGMENTS SCAriCH — <br /> - <br /> ENVIRONMENTAL HEALTH DIVISION FILE5 <br /> -V'UNUCRGn0UN0 TANII (UST)CIEANVP SITE(LUN) Q HOUSING AOAIEMF.NT O SOLID WAS1E FACII•tT- <br /> •t- fOTHER CLCANVP 51TE (NON-LOP) 0 F00D FACILITY 0 SOtlb WASTE VCHICLE <br /> uNOCaGM1OVNV TA14K(MUNI TOR INGIREMOVALI Q 000 KENNEL U DAIMY <br /> 'AZARC)OUS WASTC GENCnATQrt Q CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> U 11CnC0 PERMITTED FACILITY d M0TEUHQ7Et, O PUMPER TRUCKfTAnOICHCM TOILETS <br /> O TA1 tOQIOOUY PCIRCING Q POOUSPA Q LANG USC APPLICATION SITES <br /> M U—tCAL wti,TC FACILITY Q O1HER(PLEASE SPECIFY A0OVCl <br /> List up to ton addresses In the spaco abovo. Solocl the typos) of tilos from tho list abovo by chocking <br /> (tic approprlale box(os), At (cast Ono filo type MUST be solocled. Fax to (7.09) 464.01 0 or rinall to Inc <br /> oovress Indicitcd above. <br /> E"HD will notify the appliC1nl If any EHD fibs exist. An appoinlrnont lof review will be confirmed <br /> )PproxirTlately live business days but no lator than ton (10)days atter receipt of application. Thr, file: <br /> will be held for a maxlnluttl Of fiv0 bUSincsS days for revlew. Appoln(rncnts should be SChooulod <br /> accorcliouly. <br /> 7 A t,lc that Is aClivuly being workcil on by EHO staff may not bo Imnledlately available (or rcvlow, A now <br /> .lpplic30an may Gc submiltacj wtion the filo )5 avallable. <br /> Any file not returned in the same conditlon as reloased will be rcor0anlxcd by CHD staff at the oxponso <br /> Of 1110 anpl(Catll. Future file revlows by lho same applicant may require a 100.00 deposit prior to rcvlew. <br /> 5. 'TENTATIVE appointment dates must be Confirmed with EHD staff. <br /> G. rlppllcat ons retched aticr 5:00 pm will Ue processed the next buslnes,a day. <br /> CONFIRMED APPOINTMENT UATE <br /> TIME <br /> )ATE CONf;f; AEU PHONE FAX INITIALS <br /> :6Vlr_wCD_ —_^`YES NO REVIEW OATS ^ <br />