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_- "d9/21/2004 14:22 925283 1. AEI CONSULTANTS' ? PAGE 01 <br /> 07./03/2003 15:16 464013b ENVIRONMENTAL HE. I PAGE 02 <br /> .�„ <br /> EIIU 40C�KMADLh <br /> IDD <br /> JAN JOAQUIN COUN1YPU13LIC HEALTH SERVICES � <br /> - ENVIRONMENTAL.HEALTH DIVISION <br /> 304 EAST WESER AVENUE,THIRD FLOOR r <br /> S F P 2 1 2004 $ToWrON CA 9.5202 <br /> (209)468-3420 <br /> -ALT <br /> H. PUBLIC RECORDS RELEASE APPLICATION <br /> j,_; Veli <br /> APPtlCANT 1 BUSINESStAGENCY ' 1 `�� CD./tSV�t V <br /> ADDRESS L? Ca%vn►✓Lv pic,�1Q1r� tA)':�;►1 �5a� <br /> PHONE 't2-5-T' 2S —U 00 0 25— 7.93 Cv l 2 - <br /> TENTATtVE•APPOIN7M El nnTt TRAE . <br /> (Pinaso Qlvo T to 70 bwlinmx days from date of apnitdatlon submltlbl) <br /> CHECK BOX TO EXP'EDIT>_ EQUE5T- .oa F gUEST PRt)C_SSED IN 3 BUSINESS DAYS <br /> � 3 <br /> *SIGNATURE OF APPLICA DATE <br /> FILE ADUKESS THIS SIDE EHD STAFF USC OKY <br /> I PROGRAM ELEMENTS sr-ARCH <br /> Za IA l.�tv,G �, , I L <br /> A. <br /> O W26't- LrG►vsG(�`�r,�aZ �E ��j r15 ✓ <br /> t►--I'2. E 4 P%v1 or l. L7f ( S ✓ <br /> tom, O <br /> 1W C <br /> l <br /> ENVIRONMENTAL HEALTH DIVISION PILES <br /> UNDERGROUND TANK 1 5 CLEANUP SITE;LO� 0 HOU-5MG ADA-MME TT 9-SOLM WASTE 1=A <br /> OTHER CLEANUP SITE(NON-LOA) 0 FOOD FACILITY 0 SOLID WASTE VE� <br /> UNDERG9Q(610'TANK(MONITOWNWREMOVAL) 13 pOG KENNEL O bA1RY. <br /> HAZARDOUS WASTE OPNCRATOR ID CHICKEN RANCH O PKG TREATMENT PLANT <br /> T1ERM PiERMMED FACILM 13 MOMMOTEL 0 PUMPIER-tRUr_KtTAjt01C"EM YOILETS <br /> rE3 <br /> TATTOMODY I'MCING 0 POOL/SPA E3MI <br /> GD USE A>'PLICAMK SITES <br /> MEWCAL WASTE FACILITY O OTHER(Pl EA55 5PCGtFY ABOVE) <br /> 1. List up to ton addresses In the space above. Select the type(s)of files from the list above by checking <br /> the appropriate box(es). At least one fife type MUST be Selected. Fax to (209}464-0130 or mail to-the <br /> address indic'atEd above. <br /> 2. EHD will notify the applicant if any EHD files exist. An appointment for roview will be confirmed <br /> approximately five business,days lout no later than ten'(10)days aftor receipt,of application, The files <br /> • will be held for a IT12XI ntlm of five business days for review. APPointrnents should be scheduled <br /> accordingly. <br /> 3. A file That Js,actively being worked on by EHO starf may not be immediately available for review. A.nee <br /> applicaf]on may be.submittud when the fila is available. <br /> 4. Any fire not returned in tho same condition as re(easod will be reorgantzed by EHD staff at the oxponsc <br /> or the applicant. Future f'i'le reviews by the same applicant may require a $69.08 deposit.prior to rcvicv <br /> S. *tENTATl1!>~appointment dates must be confirmed with EHD staff. <br /> .6. Applications received after 3.00 pm will be prarcrised the next lousiness day. <br /> CONFIRMED APPOINTMENT DATE, TIME ' <br /> DATE CONFIPMED PHONF- FAX INrT1AL.S <br /> REVIEWED YES NO REVIEW DXTE <br />