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05/15/2006 12:23 1310798,.'"X41 PAGE 01 <br /> a. 45a01a ENVIRONMENTAL HE FAGS 01 <br /> L <br /> Sit J04 COUNTY <br /> w <br /> UNWRONNIZriTAL REALM DEPAPTMNT <br /> '' [QQQ 304 EaA Wever Avmue,3 d Floor,ftWou,OA 95202-2708 <br /> ENVIR0I`d k-ANT HEALTIP' pho":(2M 4683420 F=(209)464-013$Web;►vww.sjpv.oWebd <br /> PERS"�l a 1SERVICES PUBLIC pECORDS RFLEASF,AFPLICATION <br /> Appucmr.-. A �CJSIIi�SS1AG�GY= �� ` ��- <br /> AVPR=S` <br /> -7-'90-b C' �lv! Ld crrf-1n'AuUk Gw�_- TAT _ <br /> PHC►! tix T. ... '? °�1" ` PHONE C4: " ,rS- 2�3�- b�F71'D _� c WUN,, � ` �,l y <br /> .�.. <br /> TENTATIVE"APPol MIAM DAIS: �irne: <br /> (p1me allow jo btAr$M dMM ftm data or appUra m aUbMW-"Tuve only-mod be oonfkmod) <br /> 'CI Ca lEdt BWt T I t RIwQ T•;e�Ga H CHECK ONLY)-REQUM PRoMMED IN!SUSMOS DAYS <br /> SIQNATURE OF APPLICANT I ATe <br /> t lec6ronlc CJ t M M Map-i>na1r�loa <br /> Mfofkn�� <br /> FILE AWRESS Jp USE ONLY, <br /> Sit Stage NameG <br /> I <br /> a , <br /> - L- <br /> S, CQET13 'l.UL.�]lnrlliit <br /> T. <br /> 22 - --------- <br /> u ':jjrit <br /> S <br /> .3pecluc Date flange of 10f0rma!?on liewestad:From , to <br /> EM IRONMEN' AL HEAL TK DEPARTIdIF,IIT FILM <br /> =:a= <br /> em TA(NC PTJ Ca 'mm ILOPj ❑t4as Abu MAW Salsa 'A$f&FA tf11'r <br /> �IiOR';.DP� L7 FOOD FAMW M WAM Tff <br /> 10Tl�[c(�oRTrOF�tdOfF4Et1 04 Q DOG VQM D DAY1Mxsrb rak`�t� 12 Ctn�r ARM 13wAS1rM? st'ifwi�=TP60ff <br /> TMM7l r1fiD FACa n1" III�x t3 FPSR'�ittres�YAFa�°Q�ae+n^..A� �dl��T9 <br /> 0 TATrOommymmlo a rrOWSPA a Lim LI s<APFUCAYk}KWW <br /> VftrA.AMD S 'tte PENST FSMMA MA AM MAUNA roR F&vjLv 1I0[+I%y4-t Ay 8:pD AA�tt�Q4�1¢ - F=uX p�FIQMXvL <br /> eW <br /> Bel the s of 5129 frena thb Mt ibOve by cite=rl0 the <br /> ac�[dr��&Ia,tite space abrnre. @¢t } <br /> to ten type{ <br /> t. � Is <br /> p <br /> appropriate box(es . At least one fila W"MUST be seiocwd. 3 4 ff to thOLadefrang <br /> j o a6Oa. 44Mss raitges v 110 not baa ep d--for ndfllti ial assistance�rittt file cl resses,aoc�t <br /> the EIp:Appowtaons receftd aAer 3:40 pra will be proased the nwd bu0neSS tt • <br /> 2. The EHV wUl nothe applicant if any E"D fll01 adsL An appolrttmant for mview vhll be Confirmed <br /> Approximatelymately bra{40}days after rr s:vlpt of sppl'� lkm. Ttle tile,-vAl1 be held far•a mmdmtttm of five bsminew <br /> days for mew. Appointments should be schedul aooard1'n9ly. <br /> 3- A file be,is aetl'+tely being vtorkod on by END stdf may not be lenrrlediately AvaiialAQ f"rfWemr. A rtetiv <br /> apP0cation may ba submitted when titre file is avaliablo. <br /> Any file hot r imed in the came cartditlon as raleaced will be reorgaaxilxed by f�fD staff�t me expense of#ha <br /> ApplicanL Future fills reAews by aha same applicant Mayr uin a$BIr.QC deposit p�ivr f o rs9tf r. <br /> �rn�ro <br /> 7Wf,1f�706 . <br />