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Not �a•3rJHd ldiol :Ick <br /> �-1�-enni na;oiHr+ rha_uI TD E£i31800 P.01 <br /> SAN JOA91JIN COUNTYPUBLIC HEALTH SERVICES <br /> E VIRONMENTAL HEALTH DIVISION <br /> AUG 13 Z001 3q4 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKf ON CA 95202 <br /> t + (209)466-3420 <br /> c PUBLIC RECORDS RELEASE APPLICATION 1 <br /> 1APPLICANT ��c`CQ-• �a �LCi7S2F. BUSINESSlA6ENCY LY VO6Jll?Q�� �'-['\�.� , ` <br /> A2DRE9s <br /> TENTATIVE"APPOINTMENT 04TE TIME <br /> (Pleas Bile 7-to 10 business daTys 5- <br /> from data o!aap/A4cat1on sut>M0W) <br /> CHECK BOX TO EXPEOITE REQUEST-Sa740 FEE <br /> --.REQUEST P.:OIa SSED 44 DllSINESS DAYS <br /> -SIGNATURE OF APPLICANT �.x.S7..�-. �M4a-os^<� DATE <br /> FTLC ADDRESS' TH15 5106.EHO STAFF USE.ONL <br /> PROGRAM ELEMENTS SEARCH <br /> - 1IZAS t` Lev RV t�3 T <br /> _� cam,t ar se -1 ovae2 c M <br /> 1 "ORx s le� _2av wk <br /> �"`r��P,� -e�sace Ltd cep A�9�f <br /> z tvos?t>1 Lis LS�\ Lye 3d,z <br /> ENVIRONMENTALHEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) D HOUSING ABATEMENT C1 SOL-10i WASTE FACILITY <br /> OTHER,CLEANUP 817E(RON-LOP) D FOOD FACUJrY Q SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITCWNC/REMbVAL) 0 DOG KENNEL 6 DAIRY <br /> HAZARDOUS WASTE GENERATOR - 0 CHIOJQ TN RANCH ❑ PKG TREATMENT PLANT' <br /> G TiEAW:PER1AITTE0 FACILITY O MOTEUHOTEL ❑ PUMPER TRUOKlYAROfCHEN TOLLETs <br /> O TATTOO=r)YPEIRCING 0 POOLMIFA ' ' O LAND USE APPLICATION SITE$ <br /> G MEPICALWASTE FAG+LITY 0 PUBLIC WATER SYSTEM C3 OTHER(PLEASE SPECIFY ABOYE) <br /> 1. List up to ten addresses in the space above. Select the Type(s)of tiles from the {ist above by checking <br /> the appropriate box(es). At feast one file type MUST be selected_ Pax to (2091 46QQ136 or Mail to the <br /> address indicated above. <br /> 2. EHD will notify the applicant it any 91-11)files exist. An appointment for review will be confirmed <br /> approximately five businessdays but no later than ten (10)days after receipt of application. The files <br /> will be held for a maximum of five bustness 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 available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EMD staff at the expense <br /> of the applicant Future file reviews by the same applicant may require a$87.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with Emo staff. <br /> 6, Applications received atter 3:00 pm wit[be processed the, next business day- <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS. <br /> + <br /> REIylEWE:D YES NO REVIEW DATE ' <br /> 1]I Ce r4 a rye --- <br /> ' � TOTAL P.01 <br /> „-1 �1­1r uni, v + rra Ira rT nnu <br />