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' if�,�`:'.A5.63Kit �•� +,a� P*J"��"'�', ��'w'�.� � `� k.�€!`� -r4,; ', r,` 4 L 1 ( '� 's��r>,r �.rsjert, rtil.�, �F4 �� tIu"�. '��2w�'�'��•�€�� , :. { K - �:, PUBLIC RFC01a-t, .tX_" APPLICATION APPLICANT: TWIT {II G NQI: ?�,><.� to ADDRESS: �/ tp/i{ C/Cli2l L44, �.. -- PHONE(1): I z S 7✓��—d-� > pHOHE(2): ACSIMILE:_ c_t: 2 'DrQ ro TENTATIVE}APPOINTMENT DATE: I -ac 7 Time:_ !� � r"1 ^�' (Please allow 10 business days from date of application submittal-*Tantahvs only-must be confirm®d) �,.__�;K BOX TO EXPEDITE REQUEST-$93.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED 1N 3 BUSINESS DAYS SIGNATURE OF APPLICANT Me` +.14k6l�t DATE (,-/ S /15-7 ,( UNIT DISTRIBUTION ❑ Unit 1 ❑ Unit 2 ❑ Unit 3 ❑ Unit 4 ❑ Unit 5 ❑ Unit 5 ❑ Other(electronldllswmaps) {� FILE ADDRESS END USE ONLY Street W Street Name City 1. ZGO 5e-111 0 S0-�q way c00 �� 2. (2�d' Sou i S6'� Lcix 5 {vvt us FA0 3. z!o S o�� I,t.1 i{ a� U14v S In c f 4. b0 i Is 0,14111, !34-, o WA �� S. /,2. Sa v w�ls� Gva S c�•E-crn D0 " 6. I 8. 9. lkGSo Pt S eula, ase e n--js6tAi,b P4 ►'�sSeS e+W eeh 12vo 4-t2So (6141tr 411&&, i cc i I Specific Date Range of Information Requested:Fromyp4�� ENVIRONMENTAL HEALTH DEPARTMENT FILES R UNDERGROUND TANK(UST)CLEANUP SITE(LOP) Q HOUSING ABATEMENT ❑SOLID WASTE EAquTYMHICLE M OTHER CLEANUP SITE(NON-LOP) FOOD FACILITY 0 WASTE TIRE UNdEROROUNO TANK(MONITORINGIREMOVAL) ❑DOG KENNEL ❑DAIRY �1HAZARDOUS WASTE GENERATOR ElCHICKEN RANCH 0 WASTEWATER TREATMENT PLANT 44 9 TMERED PERMITTED FACILITY C]MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEM TOILET$ ❑TATTOOIBODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES ❑MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) WELL AND SEPTIC PERMIT RECOROS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM-6:00PM - EXCLuorNG HOLIDAYS. 1. List up to ten addresses In the space above. Select the type(s)of files from the list above by checking the , appropriate box(es). At least one file type MUST he selected. Fax to(209)464-0138 or mail to the address indicated above. Address ranges will not be accepted—for additional assistance with file addresses,contact the EHO.Applications received atter 3:00 pm will be processed the next business day. 2. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten(10)days after receipt of application. The files will be held for a maximum)of five business days for review. Appointments should be scheduled accordingly. F". 3. A file that Is actively being worked on by END staff may not be immediately available for review. A new application may be submitted when the file is available. 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the 61 applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review, _ " .....,._,......_...:-...,ntr...-r.+u.wr..=.<w.wf:.nr.:>.,5..MNR�ie+1.�.:i •-(Mfievu.ws .v.....ruw ..�(:'V:.•r,.....yw.rW..JI•w#i:F.+.iW1•Nw:1.MYI.»Yit%"inAU eY.SAX.�a-.4r.Wii(y'.Y,�:r«s.n::s-.w'W.'r.w'w="wtiw:AWtl, <Yt1SW�.k/t .•-1..: :.r ,' 'Yrc.rxuaX..n..I.+ry4>..:f+�.�.•MKfnnnM'L.[Mr'W-:Kunv. a r:....•2(?r>.:..•--, «.ew+'eWatliv.«wt"...i'1.u.• a E+•'<inPi.ism:✓e::Y'R+Y'#«t»bn'L%La.ikt. ;,-.: ...�' •...".... .._ ...._„-._...-...........:., ,......-..i"V;ia+rwn.veFe+..'�•...e.ar.,.+w,w:,rv'-..✓+v.'.+t✓K:ori.rNke.:.lupins+.'r.-NroW:atYysVs.YisL:.4i'+.•?�.x0.✓Yb.ra�iN::b:inu.•Nu'h�IwM.YfnYb.7g:fvFi>a'.+iiwiJF.'_w'.f..wui.XMktMW.w,✓.2ti:5-: '-::t{:.•'. r ':