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10:2iW FRC�l <br /> RUMU <br /> F \ 7--( ` :-� ; -S�N JOAQUIN COUNTYPUBLICHEALTH SERVIYES� <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE.THIRD FLOOR <br /> F rE B 2 j zool ST6CKTON CA 952 32 <br /> 't2O9)468-34.20 <br /> LTPUBLIC RECORDS RELEASE APPLICATION <br /> APpUCA!`iTMik>: ren; MUSINE01AGEMCy Henshaw Associates. Inc. �1 <br /> lIU75 Dublin Bvd, Suite A-200,� Dublin, CA 94568 -- <br /> 92 -7 Z-.,.,Z FACSIMILE 55- Ott- <br /> APPOINTMENT DATE TWE <br /> days from rielc;n aubmittal) <br /> (Ple&2o alva7 to 10 business d.�% I"clale A jkpprf <br /> ChF-rX h=TO EXPE13 ITE RE CIU EST.$37.00 FEE-RJEq"3T PR 1339DIFI SUSINIESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> FILE AtIrIF&F34 THC6 SIOE EHD 3YAFIF USE 014LY <br /> T PROGRAM ELEKNT3 SEARCH <br /> �Y 2212 2 <br /> ENVIRONMENTAL HEALTH Di-11610N FILES <br /> UNOERGROUNDTANK COST)CLEANUP SITE(LOP) (3 HOUSING ABATYME11T 0 SOLID VVAaTE:FACILITY <br /> 07MR CLEANUP SITE.(NON-LOP) 13 FOOD FACIUTY 0 SOLID WASTE VEHIC LrE <br /> UNDBROROUHD TANK(MON1T04PUNGIREWWAIL) M ID00 KENN" Cl DA174Y <br /> MAZARDOUSWA3TP GENERATOR C1 CHICKEN RANCH 0 PK(;TREATMENT PLANT. <br /> C3 TIF-RIBA PEIRMITTEr.0 FACILITY D 'MOTEUHOTEL 0 FUMPEIR TRUCKIYARMCHEM tOlLeTs <br /> ;3 TAT rOO1400YFFIRCING 0 POOIJ311A Q LAND LISF APPLICATION SrTES <br /> 0 Mr.01CAL WASTE FACILITY PusuaWATER ays:'Em C3 OTHER(PLEASE$PECIFY ABOVE) <br /> I. Llat up to ten addresser,In the space above. Select the type(s) of files from ths list above by checkJng <br /> the appropriate box(es). At least or%*filo typo MUST be ;012--ted. Fax IQ(2091 -0438 or mail Ig the <br /> above <br /> EHD will notify the applicant It any EHD flies exist. An 1.2pulnLment for review Will be confirmed . <br /> approximately five business days but no later than'tim(10)days after racelpt of application. The files <br /> will be hold for a Maximum of five business days for rGV Qw. Appointmanis should ba sehadvIed <br /> accordingly. <br /> 3. A file that is actIvely being worked on by END staff may not be Immediately available for review, A new <br /> application may be submitted when the flin Is avallablie.. <br /> 4. Any file not returnod in the same cont!'ition as released'irill be reorganized by EHD staff at the expense <br /> of the applicant Futuro file reviswi;by the sarhe appillel nt may requira a $87.00 deposit prior to review. <br /> S. *TENTATIVE appointment dates must be confirmed IvIth EHD staff. <br /> 6. Applications received after 3:00 prn will be processed 0 0 next husirleas day. <br /> EONFIRMED APPOINTMENT DATE TIME <br /> ) ATF-CONFIRMED PHONE FAX INITIALS <br /> EEVIEWED YES NO REV]EW DATE <br /> 114 go 1w "Mmo <br /> TDTq:P.01 <br />