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10/ 03/ 2007 10 : 02 13107982PA1 PAGE 01 <br />! II. f'lyi0,�b� I�1�4?413)i 46401 $9 ENVIRQhNENTAL WEALTH PAGE 01 <br /> SA,v JOI COU1 Y <br /> r l FF00 r E>`monwriNTAL HEALTH DMIARTASNr ' � 5� <br /> 111. 304 East. Weber Avenue, 3r0. Floor, 5to*tm CA 95202-2708 <br /> to d i ) a)Lryshonc: '(209) 46$-3420 Fax: (209) 46"138 Web: WWw,sjgov.orp/chrl <br /> j IF <br /> PUBLIC RUCO"S RELEASE AF)PLICAUON <br /> AFPUCANT. �+ eUgINPSSIAGENCv: <br /> Apl?RES3: p�q0n (0 <br /> PHONE (9): C � 1 -�r5 ' 4 l___— _ PHONE (2): FACSIMILE: <br /> TENTATIVE" APPOINTA 5111' PRIF Time: <br /> (Please allow 10 businas5 days from date ati1ppRimin Subwi l - `taDfatiW II muse Pe oevNtrm" <br /> 0 ciiECK ®OX TO EXPEDrIEa De FEE (CASH OR CHECK PROCESSED IN• REPU I PROCEIN a OUSNE616 PAYS <br /> 5iGNATURE OF APPLICANT DATE p <br /> Etpotrnnfc infarmotlom © List Ll Map — Description: <br /> FILE AADR7;8S EItCI WSE ONLYI SPI ON <br /> Street lF Stoom T45mo City Unllf <br /> 7 . rrQA.IEET 1C U F — <br /> 2. , . . ❑ • Unie2 <br /> 39 <br /> umtaFFIFI , II <br /> 5. Unit 4 � V <br /> S. <br /> 7_ Units �I <br /> 9. <br /> Unite <br /> to, \J� <br /> SpaeiIlc pate Range of Information Requested: From A LL to <br /> .NvlRoNMENTAL HEALTIJ DFpARTMENT FlLgB <br /> JDNDrMgbtlNb TAeet (Usl7 CLUMP 9trIF5 (LOP) 0 HA13ATEMENT A7:18 etc FAcanYNNNrcLE ' <br /> Otxsn Cl3U " SM (N'ONkOP) 0NC9 FACNTY ��(t''yWA •. <br /> RS UNDEILGnnuNd TACKK(M0Wt0Rff4ii 0WVJk4) Cl Dot; IF © DARy <br /> bQ HFTARtl'WaWASTE GFINWIMPF LT %"=N RANCH W WASh1NATInUMATMENT PI <br /> Il4TOW PVMMMFAMM © PVMPERTRUCIV IRF010HUMTae.Er'J <br /> OFTAtjOofflQ0rPiaRCINc - QPDa S`P« E3 LAND USE APPUGrnoNSge9 <br /> 0 MED104WA2TE FAC11 nY Cd Om6R iP1 Uxc 13PPSIPY) — <br /> WELLAWSEP'Ra PijWrrR600ltasARDAVAl119U9P0PFMVRw - MONaAY-PRiPAYfi 4p AM S:4DPM F.%CI.UDttiG HCCtaAY3. FIIIIIiIIIIIIII <br /> � . LI up to ten adrimssos in the 6paee gbevo, Sblobt the types) of files from the list above by checking 1114 appropriate <br /> box(es). At least one fila typo MUST' bassloetad. paxtalxif9] apiWlsbortndlLtathaadd sjiftijtg(I ®kiQ l Address <br /> pna tanalwed after will not be aouepted —far addlUanal a¢6iatance vAth filo nddressas, Contact the EHD, AppfipaU <br /> 3tpp pm will be processes the next business day, 1 • <br /> 2. The END will notify tho gppilaant if gnyOD film exist, . An appointment for review will be confimted Apprw6matelyten (10) <br /> days after receipt of applicatlom The Ilia$ will be held for a mnxlMurN of five bus(unss days fir mvlaw. Appolntmants <br /> should be 6oiledU16d accordingly. <br /> 3, A file that Is actively being worked an by EHO staff may not be Immadiotoly aveliahle for .evlow. A now appil0ation may be <br /> submidaCl whan the fila is available. ' <br /> 4. Any file not returned In the some oondtffon as rslaased wid be reorganized by END staff at the expenen of the eppllc6nE <br /> FV.isure ole ravlews by the sDma applicant may regolrn a $86.00 depDRit prior to review, ., <br /> EHO USE ONLY <br />