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ll() �J.. i.. _ <br /> �07L20-2001 i09 47RM FR,,,., TO 1y166t>jIbbo <br /> I i.a i 11, <br /> (las)4$8-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> JJb ���AAPLJC�iJIT{'J !'T.FEI �'�Q�7;l�{Zlf� <br /> —BUSINESS/AGENCY G)ej::�C2.RN S t N C. <br /> '}+ADR SS ."; �,2��� PR.oSF' T -pR 5� <i-7E Rr�c�Ctya gg! i d ,CAT�o-to <br /> PHONE L l(o) � a_- t em rAcsIMILE L9tco� 4's5 3 —{8�d <br /> TENTATIVE*APPOINTMENT DAT> 3 C LN2�- D r TJMe � -P <br /> (Plersc Dive 7 to 10 business dCays troln date o!+application submittal) <br /> 31 wtt� t312r►.tG1 i'rCK <br /> CHECK BOX TO EXPEDITE RE9,UEST-$47 FEL--REQUE=ST PROCE5SE JN 3 BUSINESS DAYS C*-s f►PP'r 1+'l_ <br /> SIGNATURE OF APPLICANT DATE <br /> .' FILE ADDRESS THIS$IDE EKQ STAFF USE ONLY <br /> PRQORAM ELEIAENTJS SEARCH <br /> '725 Cou�zR.Y et. vi) rocr r-I 35a ip <br /> COUf3-'Ja SfbCK <br /> Zt �=vr+'TI�Nf3• IJ(�av S l�L-1'Cye.l <br /> Ctrvr�'TP•`t s'T�C�-Ta►�S 3�•�(, PLw . <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> .UNDERGROUND YANK tUSTI CLEANUP SITE(LOP) 0 HOUS1NU ABATEMENT 13 SOLID WASTE FACILMY <br /> OThER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY 0 $OLM WASTE VEHICLE: <br /> Q AR40ERGP-OlmD-TAHK4mcL Na--Q.; fRr--movAL) -0 DOc;_KgXNEt.- -- _O_DAIRY_ <br /> .t3 HA,ZAROOVS WASTE GENERATOR 0 CHICKEN RANCH I; PKG TREA-HENT PLANT <br /> 0 TIERED PERMITTED FACILITY 0 MQTEOHOTEL la PVMPERTRUCWTARD/CHEM TOILETS <br /> C TATTOOM00Y PEIRCING L7 POOUSPA "` 0 LAND USE:APPLICATION SITES <br /> O MEDICAL WAST6.FACIUTY Q PUBLIC WATER SYSTEM 0 OTHI=R(PL2ASI:SPECIFYADOVL) <br /> 1, list up�b ten addresses in the space above. Select the type(5) of files fmm'thir list above by checking <br /> the appropriate box(es)-'At feast one file type MUST be selected. Fax to f2") 464=0133 or mail to the <br /> address Indicated above <br /> 2. EHD�will notify the appllCant if any EHO files exist. An appointment for review will�e confirmed <br /> appFOximately five business days but no later than ten.(10) days after receipt of application. The files <br /> Will be held for a maximum of five business clays for review. Appointments sh <br /> accordingly, ould be scheduled <br /> 3. A file that is actively bding worked on by EHO staff may not be immediately available for review. A new <br /> application may be submitted when tho fsle.is available. <br /> 4. Any filo not returned In the Sartre condition as relcayed will bo roorganizfld by EHD staff at the expense, <br /> Of the applicant. Future file revlolnrs by the sarno applicant may require a$87.0b doppsit prior to review. <br /> 6. "TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3.00 pm will be processed the next business day. <br /> ;CONF{RMEb APPOINTMENT DATE TIME <br /> inATE CONFIRMED PHONE FAX INIY(ALS. <br /> i <br /> F2EVlEWt=D YES NO REVIEW DATE <br /> cn ao a aaorroo ' <br /> TOTAL P.02 <br />