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' --� �.� .. ,coot :ice•�iFjj`j eI <br /> TO �.� 85BT900 p.01 <br /> SAN .10AQt1ifV DOUNTYPULIG HEALTH SERViC <br /> i:lin,ES <br /> WJlwuii; <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 1q1 EAST WEBER AVENUE,THIRD FLOOR <br /> s^TOCKTOiY CA 90m <br /> )468-3420 <br /> PUBLIC'RECORDS.RELEASE APPLICA`rIoIq <br /> _ <br /> $USENFS$1AGENGY OAo- <br /> t <br /> P �pttlE �OO � - . �4yiQl�9 4.1 �sE .9A <br /> FAC9tMJLE �] �P\ �r 2 <br /> 40 <br /> TENTATIVE-.App 04TF <br /> (Pleosq 4i �tQ iD bustnassicta7a ZN <br /> TIME/C� (CHECK 90X TO EXPEritTEF QUFST-W.00FEb RQQUEST PRpBUSINESS-SIGNATURE OF APFLICANT �3,�� DAYS <br /> +» DATE •��i ae�t <br /> FELE ACDREss' — <br /> _t_ 'CHtSia�E EF{O STAFF USE.ONLx <br /> -9(E <br /> PR 0 LRAM ELEMENT8 SCARGH <br /> �'CpCY�C4�.j 'V912-1,,, <br /> 'CID FA <br /> 351 02 ,✓JG <br /> EIdViRONMENTAI_HEALTH DIVISION FILES <br /> UNDERGROUNQ TANK(LUST)CLEANUP WtF.{LQPI Q Hai}SINO ABATEMENT <br /> (50gn CLEANUP.517E(NON-LOA) © FOOD FACILITY 0 SOLID WASTE FAClL1TY <br /> QNOERJGRauil TMK(iApM t'oFtINGfR>=Mk?YAL} C1 FOO FACtU. Q Soul)WAS'T'E VEHII <br /> IO HAZARDOUS WASTE GEz�IE y TOR Q CHICKEN kANCtl C3 DAJRY <br /> Cl TIEREt3 PFJtl4tl7ED RAC}!tlY t3 MOTEUWOTRL PKG TREA7WrNT PL.A#T <br /> D TA�r r=30DY Pt~tRCING CJ POQI fSPA 0 PUMPER TRUCWYAR(NCHjEM T0111=7S <br /> 0 MEDICAL WASTE FAC UTY O PUgl,lC WATER SYSTCNi d LAKD USE APPLICATION stTES <br /> OTHER(PLEAS!"SPECIFY ABOVE; <br /> 9. <br /> List up to ter1,a tldrgsses in the space above. SelaCt tho types) Of files front the list above by chec.cing <br /> the appropriate b*x(es). At least one file type MUST be selected. F t 2 9 A i3 <br /> a¢c[tass indicat$d above mail the <br /> 2• - EHD will notify the appitcan if an — <br /> .W111approximately five business days but no later than en(�)days afteroreceipt of appllcatlon. The fires <br /> accordingly, <br /> be held, a maximum of fVa business days for tevieW. Appointments should be Scheduled <br /> sCcorrliAgiy. <br /> • •A file that%s 4Ctively being worlsod on by EHD s <br /> PPitcatlQfl may Ire staff may npt be imrnediat ly available for review. A now <br /> 4. ubmitted when the 1110 is available. <br /> Any file not returned in thA same condition as released will be 15 *TENTATIVE appointmreorg;j I, staff at the expense <br /> eq by END <br /> of the applicant. Future file reviews by the same aAWieant may require a $$7.00 deposit prior to review. <br /> ent dates must be confirmed with EHD staff. <br /> g• Applications received after 3:00 pm will be processed the next business day.. <br /> CgNFIRNIED AFPOIIy*-MENT pATf <br /> TIME <br /> DATE CONFIRMED <br /> i PHONE PAX INITIALS <br /> R�li>EW�U <br /> YES NO,• ,�� REVIEW DATE ' <br /> TOTAL. P.01 <br />