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/ RI <br /> FROM rCTE-Esc. FAX NO. :7605460328 Jun. 17 2002 11:36AM P1 <br /> -_ Airnuvt`u ! 4 y ENVIRONMENTAL. HEALTH - PAGE 01 <br /> w SAN JOAQUIN COUNTYPUBLiC HEALTH SERVICES OT VM IWaEEA <br /> ENVIRONMENTAL. HEALTH <br /> DIVISION <br /> y 304 EAST WEBER AVi=NUE,THIRD FLOOk I <br /> �'`' 1 ; r'r i 1: 3 fi Sro2os)4s zo�oz <br /> c'1. PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT,_ �r4�e�e'l.( 11USEWSSIAGENCY GrK4rvc h An tri <br /> ADDRESS V,he � C �'�"'� <br /> S�'�. G Esconclr'c�o ly 9'202 . <br /> PHONE ?Go 7Y6- K455 T,FACSIMiLE 7ba� 7Y4- $'O(v <br /> TENTATIVE"APPOIMENT two_ 6�2S�OZTIME 4/: 00 "A <br /> (PLeAsa gi�v&7 t�o 10 bu�ale a a M dAte o rppllcntion vubMIttal) <br /> CHECK BOX TO EXPEDITS RIMEST•589.00 FEE_REqUquE T gP OO���� <br /> ES <br /> SE N 3 BUSINESS PAYS <br /> SIGNATURE OF APPLICANT DA7E <br /> FILL ADDRESS THIS SIDE;EHO STAFF US8 ONLY ' <br /> PROGRAM ELEMENTS SEARCH <br /> 3 OS EI �} <br /> 4 �o i o S'fr�e� <br /> 20 <br /> f] <br /> ENVIRONMENTAL.HEALTH DIVISION PILES <br /> tNDERQROUND,rANK <br /> NDERGROUND TANK(UST)MANUP SiTE ILOP) In HOUSING ADATliMENT A SOI,lA WASTE FACILITY <br /> THER CLEANUP SITE(NON-LOP) O FOOD FACILITY ❑ SOLID WASTE FACILI.E <br /> (MONITORING/REMOVAL,) q DOQ KENNEL O DAIRY <br /> Q HAZARDOUS WASTE GENERATOR b CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> Cl TILTED PERMITTED Y <br /> 0 /RobfNr, O MOTELIHOTCL M PUMPER TRUCKJYAR01CHttM TOILETS <br /> 7 MEDICAL WASTE FAC!nY D POOt.MPA CLAND USE APPLICATION SLDS ,- <br /> , <br /> 0 PUBLIC WATER SYSTEM b OTHER(PLEASE sPECIFY ABOVE) <br /> 1. List up to ten addresses in the spare above. Select the type(s)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to 09 464.0138 or Wall t9 thl <br /> pAdr2 ss indicalted above <br /> 3. EHO will notify the applicant if any END files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than tori(10) days after recolpt of application. The flies <br /> will he held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by END staff may not be immedlataly avallable for rovlew. A new <br /> applicatlon may be submitted when the file is available. <br /> 4. Any file not returned in the same condition as releasbd will be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a$89.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with END staff. <br /> .61 Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE. TIMi" <br /> DATE CONFIRM90 PHONE FAX <br /> INITIALS <br /> REVIEWED <br /> n„� YES NO REVIEW BATE <br />