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10/13/2002 23:37 17079773276 ANTON GEOLOGICAL PAGE 02/02 <br /> 139-04-7WJ11 09:2SHP 'I 1 Iu 1namrrrrx'rb r.Ul <br /> 1 ��Y I COUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> O STOCICrON CA 95202 / <br /> (209) 46"420 ( <br /> I PUBLIP RECORDS RELEASE APPLICATIO <br /> aPPUC�NT oa• E/.I NTO <br /> I <br /> BU31NC3S)AGENCY CIL <br /> >Di1FEss D, aDK 37J I LlE CA 9s s Z 1 4 2002 <br /> 'HOnE_! 7o7-1 ) - 3Z7Sf 1. '�yPAACSSInIM•iLLi 7o-7- S--77 -X7, 32 7(�•—�T�efftEiln�'ff-hH-++ ht�•H <br /> j TeNTATIVE'APPOINTMENT:OAT1: �L++t7'I, l7, yt/��Z TIME <br /> C �,dour sFRyir,Es <br /> (PIC25.e:-c 7 to in as tin a n dui �Pplieo " n SubinliWD <br /> Al CF1E`CK BOX TO•CXPEDITE REQUEST=$27 - C�5 11U5 ESS DAYS <br /> IGNATURE OF dPFILICANT DATE <br /> i <br /> I <br /> i <br /> FILE ADORES THIS 811312 EHD STAFF U5G ONLY <br /> i PROSKAM PLEMENTS 3CARCH <br /> 2151 ' ,.vrrl YaGIC.�O <br /> Z V dwNlrr•{ @Gu tom] <br /> 2 "75i Cw 3 lZ7 <br /> I <br /> i <br /> I <br /> ENVIRONMENTAL MEALTH DIVISION FILES <br /> UNDEAGROUNV TANK(UST)CLEANUP 91TE(LOP) ❑ HOUSING ADATEMCNT ❑ SOLID WASTE FAGLIIY <br /> ♦ OTHE CLEANUP SITE(NON-LOP) Q FOOD FACILITY Q SOLID WASTC VEHICLE <br /> y <br /> UNDORQRQUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> TK-M+DOUS WASTE GENERATOR O 'CHICXaN RANCH O PKG TREATMENT PLANT <br /> 1 TIER110 PERMITT40 FACILITY O tAOTEUHOTLL ❑ PUMPER TRUCWYARDICNEM TO(LETS <br /> TATTQO)BODY PYIlIC1NG Q POOUSPA - O LAND USE APPUCATtON SITES <br /> MEDICAL wA3,rd FACILITY D PUBLIC WATER SYSTEM O OTHER IPL'EA$G SPECIFY ADOVE) <br /> I <br /> I- List up tp ten addresses in the space above. Soloct the type(s) of files from the list above by checking <br /> tSe appropriate box(es). At least Ono filo type MUST be selected. -FilK t 464.0130 or mail to thy <br /> address.indicated above. <br /> ?, i EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> 1 approximately five business days but no later than tan (10) days after receipt of application.-The files <br /> i will be hold for a maximum of five business days for review. Appointments should be scheduled <br /> j accordingly. <br /> I ' A filo chat is actively bcinB;worKed on by END staff may not bo immediately available for roviow- A new <br /> application jTIQY be subriiltiod when the filo Is available. <br /> 1. Any file not:returneq in tho same condition as released will be reorganized by EHD atal(at the expense <br /> Of the applicant. Futuro flip reviews by the same applicant may require a$07.00 deposit prior to roviow. <br /> 'TENTATIVE appointment utas must be confirmed with EHD staff. <br /> I: 1 Applications received aftet 3:00 Pm Will be processed the next business day. <br /> :-ONFIj'RMED APPOINTMENT DATE TIME <br /> )ATE CIONFiRMED PHONE PAX INITIALS <br /> i <br /> 2E'V1EV1fED YES NO REVIEW r14TF TOTFL P.01 <br /> N MIMn <br /> r <br /> r <br />