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13:50_rAx. _ G�no� <br /> Y SAN JOAN COUNTYPUBLIC <br /> HEALTH D SIO�IC�S <br /> ENL iRONMENTA <br /> 304 FAST WEBER AN CA ,THI D FLOO R <br /> 2003 tiO3 SToCKTO <br /> {jos) 468-3420 <br /> PUBLIC RECORDS RELEASE APPLIC_>'< _. <br /> ' <br /> Now w BUstNESWAGENGY7� <br /> APPLICANT <br /> lv qlc <br /> ADDRESS <br /> �Co FAC51lsA1LE <br /> PHONE "I <br /> t314 <br /> ��Ur� l�',�� TIME __`'l Ate- _�_�•.-� <br /> TENTATIVE'APPOINTMEN-r nATE VLb-) llcatlon scibmitla�l ZyU <br /> (Please glue 7 to 10 business days from date of app I�-� � <br /> OCEggFD IN 3 6U..[NL53[ <br /> CHECK BOX TO E7CPEDf7E Ri=0UE5T 378.00 FEE-RLQ J 'IDA rE: <br /> SIGNATURE OF APPLICANT <br /> TI-Its �tts�aMLy <br /> Ftl�ADDFIES� PRC1GRAM E_LUMENT5 SEARCH <br /> � l <br /> air 3 <br /> v � ( fin• I.LLw� � t.1y�1. � � � _y <br /> Q <br /> ENvIRONMENTAL FIEALTH IDIVISION FILL S <br /> J�13AT7=MCeNT Ca ;.joL11)WA5TC F"AGIU'rY <br /> I/UNL)ERGROUND TANK NST?CLEANUP 51TCl HOLI5ING E(LOP) Cl FOOD)~ACIL AT 11 :30U()WASTE YEHICI.rr. <br /> C3 OTHFR OLFANUP SITE 1NON-LOP) © DOG FCENIIEL l7 [)AtFI#' <br /> ta'UNDERGROUND TAt1K tMONtrLilatitilC�IREMdVAt) O CHICKEN RANCH t, PKG TRp MEf �`U1NT <br /> 0 HAZAF2DouS WAsTE GENERATOR la MOTELlHOTEL I S LA.Nd '1=R V. ppu ATION U TOILETS <br /> 0 TIERED PERMITTED FACILITY d pooUSPA I7 IAPB"+USE EASE.sPEGI ASO <br /> C3 TATTOQIRODY>PEIRCING CI PUF313C WATER SYSTEM 13 7THl;R(PLEASE.SPECIFf AB{3VE} <br /> © r4EDICAL WAM FACILITY <br /> List up to ten addresses In the space above. Select the type{s} of lilesto.90��l'st lb ii or mail 1 U kin{ <br /> 1. a MUST be selected. 1 = L --L� <br /> the appropriate box(es), At least one fila type <br /> ddr ss 1 dic t ove. oirlisnent for r>:vieYv will be c:onFirmed <br /> EHD will notify the appitcant if any EHD files exist An aPP _re <br /> p p llc,3tion_ The flies <br /> approximately five business days but no later than ten {14} days <br /> oilreil ��ts should bba scheduled <br /> will be held for a Maximum of five business days for review. App <br /> accordingly. <br /> ly lasing worked an by EHD staff may not be irnrnedtal:ctly available <br /> g. A fila that is activei��r rvvlew• new <br /> application may bra submitted when the file is avallable. <br /> r iew. <br /> 4. Any file not reWrn+lid in the same condition as released fltrtay rar ube •sreZ���7 y EHD sQa[f aOM expense <br /> ii'v <br /> of the appliCant. f=uture file reviews by the same applicantiEHp staff. <br /> 5, "TENTATIVE appointment dates must be -onfirmed W t <br /> g, Appllcatlons received after 3:00 pm will ba processed the next bw;iness da <br /> _.,..._. -- ------- <br /> I CONFIRMED APPOINTMENT DATE � TIME <br /> - PHONE FAX <br /> II�IITIAI.sLDATEONFIRMEDYESNOREVIEW DATE.....ED. V, P.4 SGlf> f r.t�� Os 4t 1,�uoo 5 F 0 3' 01cf�,/'n I cM i i h��� 3. GIS. TOTAL P.02 <br />