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FROM NOR Environmental PHONE NO. : 209 369 4228 Aug. 07 2002 04:46PM P1 <br /> 5..,,I OACUIN "UNTYPUSIIC HEALTH SERVIC <br /> 40 <br /> 500 F,iIVIAZTWMYiAL.HEAl.7NDM3lON -9-5 p <br /> ava �OM� AUG 0 8 2002 <br /> PUBLIC RECORDS RELEA SE APKICAT10H PER MIT/RL T HEr:Q <br /> APPU4AN7 •CIL (�'(-� = NEIL D. MvhG-t�.'�ON 4 ASSoG <br /> At]ORESE � I�1. H'0 US i b f`l l.A-n�E, Eyi CF} �1 <br /> wwHa ?1Xr- r3lo - 3 PACswar `Stn R 4228 <br /> TENTATM-APPOINTUDR TM? •2.Z <br /> lFlaawen.rw,eti tmE <br /> N •Fa�weaa ► <br /> Q cHEdt 607c To t'JGM=REDUEar. inwl a.� <br /> SIGNATURE OF APPLICANTDATE <br /> Pq.EAppKeay <br /> to <br /> t .re <br /> wfl e-- r <br /> 1 <br /> MOMM MAL HEALTH I QN Fam <br /> Cpl U>IDER2RC1=TAMKtMCXSAW tdiXp.DFI Q "OUMA"TatmT 0 mmvuwm FAcam <br /> tmtaltCLSAia/}ellipi Q aOI.IDtr/atiatBtiviattE <br /> NOTJINK�YALt m Q tam. - a <br /> nzzae Q OaR <br /> Q T0=fSMKMWf'ACU.Ya a "wTh <br /> "Timm"Ar <br /> Cl rgnmpm7nacwAffncrmmTwLm <br /> a TaTlooiaaDrvweoala <br /> aUMCALWAMPA== t] PtmUCvATmzTXTw M o&iA rA3M15 <br /> 1. Up to tan in tt,e•Paso above. S*lW the type(s)aft=t=n the W abase by dwddnq <br /> tho <br /> (�1• A!least toss tRe type tVlUS7 be eetoatsd, Fax m(20}!I 164.0138 Orman te,l,. <br /> 2 mm va mmy the evicant K mty EHD 13"QxbL An appob+t�R for to,dasr vA be WWkMd <br /> spin <br /> nmbUwnfta da"Wot of itr. w ttun ten(10)days slier.stwip zfwu=dm the lmrs <br /> daystar rav►wr. Appdtotmeeta should ba schadided <br /> c <br /> 3. A f1w that is aadvoiy belrt6 worked an by EHO stat!mss not be lmmed trdy:vaDabta tar rorLw Anew <br /> 4. aPPl don may be aubnditd Wtum the fila Is a w4Uable, <br /> A�tDe not tsttnnMd In ale setno conte*l�stWH1 bs i oa. =ad by EHO 9tak 9dtha <br /> qxpwm <br /> applksfrt. Fubuo fAe n,rievra t,y the setae <br /> S 'TENTATNH appoirdme d dates rover be mimed wlth r ue e;TB 0D deposit prior td rwtwr. <br /> {8 Appf, ned i�rad attsr 3= Wt <br /> pm wiU be pracssw the next tnnirmee,day. <br /> I CONFIRM® APPOIMMENT DATE <br /> TttdE <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES ND REVt£YvDATE <br /> ..v <br />