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FROM : Geo—Phase Environmen;Jr1c. FAX NO. 2095690255 Jun. 27 2000 03:03PN Pi <br /> -- y SAKI J(7AQUIN GOUNTYPUBLIC HEALTH SERVICES np <br /> ENVIRC)NMENTAL HEALTH DIVISION /7 21 /^ <br /> 304 EASY WEOER AVENUE,THIRD FLOOR ���//////"�VV-� <br /> STOCKCTON CA 95202 <br /> .. - <br /> (209)468-3420 Z <br /> Y. PUBLIC RECORDS RELEASE APPLICATIONEN� T �a0 <br /> APPISCAH7 g`�k �A.�+Sa.f BUSINESSIAG>=tdCY_ �_ rist�l< V <br /> -•�y�GEs,,. <br /> ADDREss 99 37.. VE"jE_em 4�J AVr:,' 'to ELM � C1 �'351� <br /> FACSIMILE <br /> 2-CA is Lna1 - <br /> TENTAT(VE'APPOIN'fMeNT DATETIMe <br /> (Please give 7 to io business days from ciao+of application submittal) <br /> 10 CHCK BOX TQ EXpF DiTE RECIILEST-$7`6._0C FEE-•REQUEST PROCESSeD IN 7 BUSINESS DAYS <br /> SIGNATURE OF'APPLIGANT `�`� � ' DATE _G{aI?;loc� <br /> AL-ADDRESS <br /> 30 i 3S ,23( <br /> '2 Lo a 5 I19AL,4 rxriHvR �� `7'l�Jt,G �G a 7 � � <br /> is pD W 5T IF uT 1[,D 7u3 k <br /> 1 I. <br /> i <br /> ENVIP20NMEHTAL I{EA�DIVISIOI;-r11rE—S <br /> 10 UNDERGROUND TANK(UST}CLEANIfP SITE(t QP) [I HOUSING ABATEMENT d SOLID WASTE FACILITY <br /> O FOOD FACILITY ❑ SO <br /> is OTHER CLEANUP SITE tNa�-I_OpSOLID WASTE vEHECLE <br /> 0 UNDERGROUND TANK(MONITORAIG19EMOVAL1 ❑ DOG KENNEL Q DAIRY <br /> I7 t;}{ICKEhIEutNC1�3 ❑ PKGTREAT1�tEAITPl11NT <br /> 15 HAZARDOUS WASTI:GENERATOR O M4tCKEN RAN o PURIPERTRUGK1YAAn1cHEM TOILETS <br /> O TIERED PER-MiTTEn FACILITY d MOTELJHOpOCLISPA ❑ LAND USE APPLIGA=N SITES <br /> C TATTORIBOOy PEIRCING p FUSLSC wATCK SYSTEM n oTHE;R(PLEASE SPECIFY AROVE) <br /> M MEQfCAL WASTE FACILITY <br /> 1• L(st up to ten addresses in the space above. Select ttie type($) of files from tno list above by checking <br /> the appropriate box(es). At least Eine file type MUST be selected. Fax to Zf)9 4 4-0135 or ail to t <br /> address indfr_ated ata ve. <br /> 2. EHO 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 ten(10) days after receipt of application. The files <br /> will be held for a maximurn 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 availahle- <br /> q, Any file not returned in the same condition as released wall be reorganized by EHD staff at the eXpOnse <br /> of the applicant. Future file re�liewS by the Same applicant may require a$78.40 deposit prior to revievt. <br /> 5. *TENTATIVE appointment dates murt be confirmed with F-HO staff. <br /> 6. Applications received after 3:04 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME - <br /> DATE CONFiRMEO PHONE FAX INITIALS; <br /> REVIEWED YES NO REVIEW DATE <br /> EH LO 14 DUOUDD <br /> �i, <br />