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i 1 LJ JJ 0(ZZJb8 <br />DATE RECF-1 s� R <br />SAN JOAQUIN COUNTY <br />h ENVIRONMENTAL HEALTH DEPARTMENT' <br />600 East Main St. Stockton, GA 85202-3029 <br />?TellephOne: (209) 468-3420 Faux, (209) 464-0138 Web: www.sjgov,Org/ehd <br />AfPL�<«� <br />i.�i i4� � i� =r•� .. - - - - <br />PAGE ©1/01 <br />EHD LOG NUM BE <br />� Ill;j "t <br />ADDRESS: PO Box 1956 <br />PHONE (1); 530/872 - 2 5 8 PHONE 2: CITY/STATE/ZIP: Paradise, CA 95967 <br />TENTATIVE° APPOI NTMENT DATE () FAGSIMIL E: 5 3 0/ g 7 2_ a g g 8 <br />(Please allow 10 business days from date of application submittal . *Tentative pnl Time; <br />❑ CHECK BOX TC EXPEDITE REQUEST - $115 FE (C SH OR CHECK ONLY) . REQUEST iiust be oonflrmed) <br />81G1V <br />Specific D$to Range of information Requested: prom _--Unit��/ C]y' <br />,,.�,// ENVIRONMENTAL HEALTH 6? pARTMENT FILES tp <br />L� NDERGROUND TANK (UST) CLEANUP SITE (LOP) Q HOUSING ABATEMENT <br />�LT-J7 �O�THER CLEANUP SITE (NON -LOP) ❑ SOLID WASTE FACILITYNEHICLE <br />Lfd UNDERGROUND TANK (M.ONITORINGIREMOVAL M FOOD FACILITY ❑ WASTE TIRE <br />911AZARDOUS WASTE GENERATOR ) d CHI KENNEL ❑ DAIRY <br />❑ TIERED PERMITTED FACILITY r� CHICKEN RANCH ❑ MOTEL/HOTEL WASTEWATER TREATMENT PLANT <br />I.._.1 <br />Q TATTOO/BODY PIERCING ❑ PUMPER TRUCK/YARD/CHEMICAL TOILETS <br />CI MEDICAL WASTE OTHERPOOLI(PLEASE SPECIFY) <br />FACILITY A El LAND USE APPLICATION SITES <br />OTHER ( <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8;00 AM-5:00pm <br />(EXCLUDING HOLIDAYS) <br />1 • L►s to ton addresses In the space above. Select the <br />box(es). At least ane file types) of files from the list awbove by checking the appropriate <br />ranges will not be accepted far additional ass stince with09e a41Iddresses, contact the Eye 9A plioationsbreceiv d afters <br />3:00 pm will be processed the next business day, <br />2. The PHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten (10) <br />days after receipt of application. The files will be held for a maximum of five business days for review, <br />should be scheduled accordingly. Appointments <br />3. A file that is actively being worked on by EHD staff may not be immediately available for review. A now application may be <br />submitted when the file is available. <br />4• Any file not returned In the game condition as released will be reorganized by EHD staff at the expense of the applicant. <br />Future file reviews by the same applicant may require a $11$ deposit prior to review, <br />S. If you need further assistance, please contact Diane Martinez. at (2091 AASL'1A*9: <br />ATURE OF APPLICANT <br />�? <br />_�a- <br />vpo/ <br />ESSEb IN 3 BUSINESS DAYS <br />Electronic Information: <br />c.._. -d <br />❑ List ❑Map ,Description: <br />DATE q <br />FILE ADDRESS <br />Street# <br />-. <br />StrQet Name <br />USE ONLY <br />1. <br />2- <br />1789 W. Cltay <br />ter Wily, <br />city <br />Stockton <br />on <br />1524 <br />S. Fresno Ave <br />Stockton <br />3. <br />m Unit 3 <br />7. <br />Unit 4 <br />8. <br />_ <br />❑ Units <br />10. <br />Specific D$to Range of information Requested: prom _--Unit��/ C]y' <br />,,.�,// ENVIRONMENTAL HEALTH 6? pARTMENT FILES tp <br />L� NDERGROUND TANK (UST) CLEANUP SITE (LOP) Q HOUSING ABATEMENT <br />�LT-J7 �O�THER CLEANUP SITE (NON -LOP) ❑ SOLID WASTE FACILITYNEHICLE <br />Lfd UNDERGROUND TANK (M.ONITORINGIREMOVAL M FOOD FACILITY ❑ WASTE TIRE <br />911AZARDOUS WASTE GENERATOR ) d CHI KENNEL ❑ DAIRY <br />❑ TIERED PERMITTED FACILITY r� CHICKEN RANCH ❑ MOTEL/HOTEL WASTEWATER TREATMENT PLANT <br />I.._.1 <br />Q TATTOO/BODY PIERCING ❑ PUMPER TRUCK/YARD/CHEMICAL TOILETS <br />CI MEDICAL WASTE OTHERPOOLI(PLEASE SPECIFY) <br />FACILITY A El LAND USE APPLICATION SITES <br />OTHER ( <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8;00 AM-5:00pm <br />(EXCLUDING HOLIDAYS) <br />1 • L►s to ton addresses In the space above. Select the <br />box(es). At least ane file types) of files from the list awbove by checking the appropriate <br />ranges will not be accepted far additional ass stince with09e a41Iddresses, contact the Eye 9A plioationsbreceiv d afters <br />3:00 pm will be processed the next business day, <br />2. The PHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten (10) <br />days after receipt of application. The files will be held for a maximum of five business days for review, <br />should be scheduled accordingly. Appointments <br />3. A file that is actively being worked on by EHD staff may not be immediately available for review. A now application may be <br />submitted when the file is available. <br />4• Any file not returned In the game condition as released will be reorganized by EHD staff at the expense of the applicant. <br />Future file reviews by the same applicant may require a $11$ deposit prior to review, <br />S. If you need further assistance, please contact Diane Martinez. at (2091 AASL'1A*9: <br />