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BB-14--ahel er%;2UF1M FR44*,� To ` , iyi6B5291U P "U <br /> LF <br /> i SAN JOAQUIN COON*TYPUBI..IC HEALTH SERVICES <br /> �=•..,r.:w�.+- <br /> rI � � R <br /> VL UG* 2 0 2001 ENVIRONMENTAL HEALTH DIVISION _ .. <br /> 304 BASF Wt�i3>I•tR AVBNUS,THOM FLOOR q S <br /> E. ii;,« .. -s;! Al H. smcKronlc.�►9s�zot <br /> PUBLIC.RECORDS RELEASE APPLICATION <br /> MrUCJ1N1 . '� — . -- Jt�ausu+!fissrav <br /> Sxwee- for—br. 4Len R JXWO , car g t C G a%PP-42- <br /> RHONE q�Ar 1.[1'al."t 1 d FACSWe1 % e_— as 11-2— <br /> I <br /> 1-2 - <br /> r <br /> .'7ENTAT1V;E"APPov4TucmT DAA T+>tfa <br /> (Pir-z Vyg 7 to IQ busivase d4y frau alto of appllcaRoa VAW M WI) <br /> CMXCK 9Ox TG.EKPQXM REQUi:9T•. AQ p -. QUIST P Et7 tN 7*BUSMSS PAA <br /> SIGNA�RE Of APPLICANT DATE <br /> ALE J=Ot)E W THE SlnZ Eao S AM va W11t_Y <br /> PR¢CRAM BLE14RWM$$ARCH <br /> a <br /> ENVIRONMENTAL HEALTH DIVISION FILF.3 <br /> OSRO'uNDTAW(UST)GLEAM P.3 (LOP) O NQUSINGAAATAIWAT 3*UV VVAaTE FACWTY <br /> ="Jfk!'VM VK* .0P) O FOW PACNM t7 SGUO WASTE VEHICLE <br /> RO=T^W(M*ffQMWRtMQVAL) O DW ncJ6l+UHTsI O CAUW <br /> 1NASTS GSNSRATOR Q CHNXIN RN9C3j O PKG*r=ATMV4T PLANT <br /> r<A:rly Q Mgt18uNOTftt, d FUIWsFJi tRUCntfYai�rCft�t TOM.E�f3 <br /> D YA P CWG O POOLAPIC ' ' t] LO UM APPUCAYM SM <br /> Q MEDICALWAVdAH <br /> FA LITY Q PUOLICWATMSYVZM Q OTKZR(PLW8sPECWYA00Vp <br /> 1. I :USt UP w tan addresses J'n the speCe above. Select the types)of flies from the ikt above by Chacttin0 <br /> I ,ttie appropriate box(ep). At least one filo type MUST be selected Fa tg f2O9)4ti4.0138 or MAILtQ the <br /> :$ dren ind`>lted above. <br /> .2, j E14D will notify tate apptiCant if any END ries Wrist An appointment for review milt be corAnned . <br /> .approximately five business days but no later than tcn 00)days after receipt of appkadon.•T'he files <br /> i wiEtb's held for a rnaDlmurp of five business days for review. Appointmants should be scheduled <br /> i ;uGardingty. <br /> 3. A filo that is acUvoiy being worltod on by M stair may not be immediately availabie forrtrvioW. A new <br /> 4. Ippplicltlon may Ise submitted when"Rte is avaluble. <br /> e sa <br /> Any filo not raturnod in thme condition as role"ed will be rowVaniztW by 9HO aWf at the expense <br /> of the appttwrtt. Fut?M Fite reviews bar the same applic4nt may requite a$87.00 depvslt prior to rwAgw. <br /> 5. "1 EHTATIVE appointment datda trust be ooniumsd vrith END staff <br /> 6. Agpg=tlons received aft4r 3:00 pm will be processed the next businsss day, <br /> s <br /> CONFIRMED APPOINTMENT gars: T <br /> DATE CONFIRMED PHONE FAX <br /> INITIALS <br /> P-EYE MD t. • YES NO REVIEW DATE + <br /> ' rrrrry O A+ <br />