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06/22/2006 15:51 916-371•,,09 RANEY GEOTECINICf PAGE 02/03 <br /> ENVIF044ENTAL HEALTH PAGE W. <br /> 06/2E/2006 14:45 4640138 apo jvAQUIN I-IJUNII <br /> I� V+NVI�t.()NmENT,A RcAj T�DiEPARTMMNi' <br /> + a 304 East weber Avwue,3"Floor,StoeUM4 CA 95202-2703 <br /> Telq*mer(204)468-3420 FSX: (209)464-01.38 Web:WWWASPOv.of�ehdtMNE <br /> PUBLIC PECORDS RELEASE APPLICATI{p1V�NV1R <br /> APPUCANT`.+'olj n.nu� � susxfEssracENCT: rte. c "F�. <br /> CfTY W-SQG[ALrit1�—STA1E�_� <br /> ADURF.SS: ...�earL�-.Jl <br /> 2 _ t,:—0�M3rCfiLLEO� w <br /> Tme: <br /> TENIA7NE'APPOtN7M6NrDATE 6emad}_ <br /> Q�leatam 14 buabdays Rom daeoeppwwan wbmdal-'TenrawonlyMwt <br /> *e <br /> �•kN�xCf'f. <br /> LI CFi£q:60:5 TO tV?REOUEb t9b.04. -( t R'6H -FtZOU£ST PROC.ESSE iN 2 SWIN'ES3 DAYS <br /> SIrNATI OF APP ANT / �_--DATA <br /> IMYVmation� ❑ tbt Q MapLk+scApaen <br /> Flla ADDRESS E14D USF;ONLYstreets Street Name any Unit 1 <br /> 1. c}00 w Aum roc [D <br /> 2• ( t / IjIllt :Z <br /> 3. Q S• tr <br /> 4. �o W rr fel Unit 3 <br /> S. (a2ti r ✓ <br /> G. <br /> cl nt .✓ f! fCJ UnPt4 <br /> 7. Unit 5 <br /> 9. Unit 6 <br /> 10. <br /> SpeaMic Date Ranga of Information Requested:From ` l ---- <br /> ENVIRON(AENTAL HEALTH DF..PARIIAENT 'LES .J rnal , ,;� 5 <br /> NMuWAx,WA27EFAMW <br /> wDTA.nv;(usl)Cua wSM(LOP) HousMc AUTEPENT SoLVIVASTEFA6cn.14wEKMA <br /> 5A�oP site(PIOFOOD FAca►TrWA€1E'nF:ODtlOIAtOt(MmwmMKQIREVOVAU DOG KEM CLbAIn1'9 tYNnF_GEkEaATOR CmCKV RAACtiytA51TWA1FR Tat;ATmEeiT 1xWTn:9 FACLITT MOTPLWTE4PueeF'F3eTRueIWA.eo1CNEOD7P:ErtCaac PDOUSPA UwCfisc APRICATNIN saesASTE FACILITY Q1HER(FLrASIi Spec" <br /> wau MID SST C PEa ur ReDDRL£ARE AM FOR pZVk'Vt.MQNr)AY-FP�DAYS:OQ A";Ccw', • EXCUrt 1N a HaDA��_��.�w <br /> i. Last up to ten addresses in the Espace above. Select the type(s)of files from the list above by checking the <br /> appropr[W 11ox(es). At least one file type MUS be selected. F to(209148M1138 .L m til tot s,Mo <br /> fdt ab2) Address ranges will not be accepted-for additional asststanoe v th fife addresse9,oQnlad. <br /> the EHD.Applicatiot{e received after 3:OQ pm will be processed the next business day. <br /> 2. The EHD will nottfy the applicant If any EHD files exist An appoiragn ent for review wnll be confirmed <br /> appro,4mately ten(10)days after receipt of application. The files will be hold for a maxlmurn of We busing <br /> days for review. Appointments should be scheduled accordingly, <br /> 3. A file that is actively being viorkked on by EHD staff may not be Immediately availatlle far revie n, A nen <br /> application maybe submitted when the file is avaltable, ense of the <br /> 4. Any file hat returned in the same condition as released wall be reorganiied by EHD atafl at the gxp <br /> applicant Future file reviews by the same applicant may require a$93.00 deposSt Prior to review. <br /> - r`1 •c v: <br /> eea Does <br /> wrsvxna <br />