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Geo—Phase Environme c. FAX NO. : 2095690295 •Mar. 15 2002 04:30PM P2 <br /> i�G3�N 104 <br /> NTYP1 CES <br /> E L ELVQTVI ION <br /> W AVENUE,THIRD FLOOR <br /> 02 Iili,R 15 PM 02 TON CA 95202 <br /> (209)468.3420 <br /> _. <br /> 4 PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT S7P4l'& rtZ YG� BUSINESSIAGENCY C/TIl <br /> ADDREss�937 Ur-•.ewaM �/e �-,��ya <br /> PHONE_ r`6 ry ' O�q.� FACSIMILE E Opp.q <br /> TENTATIVE-APPOINTMENT DATE 42WNJ TIME <br /> ( (Please eivc 7:WFE1_- <br /> #RQ <br /> e o to of *c"on 5 llillol) <br /> CHECK BOX 70,FXP[OI7E R[QUES7•$07.0P SE 1�ISIN S GAYS <br /> SIGNATURE OF APPLICANT DATE Y14� <br /> FILE AODRE55 THIS SIDE EHD STAFF USE ONLY <br /> ? PROGRAM ELEMENTS SEARCH <br /> a«7� <br /> sr^r ar s/aria d00 / ry. fa c <br /> F <br /> i <br /> I <br /> I— <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE,(LOP) ❑ HOUSING ABATEMENT ❑ 50LID WASTE FACILITY <br /> IX OTHER CLEANUP SITE(NON-LOP) O FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> Z UNDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> ❑ HAZARDOUS WASTE GENL•RATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTCD FACILITY ❑ MOTEUHOTEL ❑ PUMPER TRUCKIYARDIGHEM TOILETS <br /> ❑ TATTOOIBODY P14IRCING ❑ POOL/SPA ❑ LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTL• FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses in the spate above. Select the type(s) of files from the list above by checking <br /> the appropriate box(es). At(cast one file type MUST be selected. Fax to (209) 464-0138 or mail to the <br /> address indicated above. <br /> 2. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ton(10) days after receipt Of application. The files <br /> will be 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 EHD staff may not be immediately available for review. A new <br /> application may be submitted when the file is available. <br /> 4. Any file not returned in the same Condition as released will be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a$87.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> E. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED <br /> � YES NO REVIEW nnT•M <br />