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06-27-'11 10:57 FROM -Geological Technics T-359 P0001/0001 F-333 <br />REWEE D LHD LOG NUMBER <br />Ir_tJ ,v'C SAN JOAQUIN COUNTY <br />JUN 2 7 All ENVIRONMENTAL HEALTH DEPARTMENT �� <br />600 East Main St. Stockton, CA 952023029 <br />6 <br />ENVIRONMENTAL HEALTH Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT:Tamorah Bryant/Cher Tonge/Elizabeth Emmons BUSINESS/AGENCY: Geological Technics Inc. <br />ADDRESS: 1172 Kanaaa Avenue CITY/STATE/ZIP: Modesto, cA 9s3s1 <br />PHONE(ly (209) 522-4119 PHONE (2): FACSIMILE: (2090 522-4227 <br />TENTATIVE` APPOINTMENT DATE: Time: <br />(Please allow 10 business days from date of application submittal .'Tentative only - must be confirmed) <br />❑ CHECK BOX TO EXPEDITE REQUEST - $122 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT qG�cdPC`M �(T)1'1 wt A/J DATE LOIa--� �( I <br />Electronic Information: ❑ List ❑ Map - Description: <br />to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILESI <br />91 UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT <br />FILE ADDRESS <br />OTHER CLEANUP SITE(NON-LOP) <br />EHD USE ONLY <br />❑ Unit 1 <br />!� ( O <br />Unita <br />❑WASTE TIRE <br />Street # <br />Street Name <br />City <br />1 <br />230 <br />Industrial Avenue <br />Ripon <br />2 <br />850 <br />w Mil go Avenue <br />Ripon <br />3 <br />16520 <br />E Milego Avenue <br />E Mileego Avenue. <br />Ripon <br />on <br />Ripon p <br />p NU CO/9 <br />Unit 3 <br />4 <br />16197 <br />5, <br />16791 <br />S Milpgo Avenue <br />M,ilc/90 Avenue <br />Ripon <br />Ripon <br />n <br />V �' <br />C Unit a <br />S, <br />16790 <br />7. <br />❑ Unit 5 <br />8. <br />9. <br />❑ Unil G ' <br />10. <br />Specific Date Range of Information Requested: From <br />to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILESI <br />91 UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT <br />5 r — <br />❑ SOLID WASTE FACILITYIVEHICLEP/it �tJ� <br />OTHER CLEANUP SITE(NON-LOP) <br />❑FOOD FACILITY <br />❑WASTE TIRE <br />UNDERGROUND TANK(MONITORING/REMOvAL) <br />DOG KENNEL <br />©DAIRY <br />HAZARDOUS WASTE GENERATOR Of <br />❑ CHICKEN RANCH <br />❑ WASTEWATER TREATMENT PLANT <br />❑ TIERED PERMITTED FACILITYL <br />❑ MOTELIHOTEL <br />❑ PUMPER TRUCKNARD/CHEMICAL TOILETS <br />❑ TATTOO/BODY PIERCING <br />[❑ POOLISPA <br />❑ LAND USE APPLICATION SITES <br />❑ MEDICAL WASTE FACILITY <br />OTHER (PLEASE SPECIFY) (,AAJUI- P71 <br />eI-A6Y6jA',nCt'� rp <br />WELL AND SEPTIC PERMIT RECORDS AREAVAILABLE FOR REVIEW: MONDAY -FRIDAY 8'OO Ant-5:OOpm iExcl lin1Nr. Hni Inevgl <br />1. List up to ton addresses In the space above. Select the type(s) of files from the list above by checking the appropriate <br />box(es). At least one file type MUST be selected. Fax to (2091404-0138 or mail to the address indicatod above Address <br />ranges will not be accepted - for additional assistance with file addresses, contact the EHD. Applications received after <br />3:00 pm will be processed the next business day. <br />2. The EHD 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. Appointments <br />should be scheduled accordingly. <br />3. A file that is actively being worked on by EHO staff may not be immediately available for review. A new application may be <br />submitted when the file is available. <br />A. Any file not returned In the same 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 $122 deposit prior to review. <br />Gun use nui v <br />&tifilO�ITIPA M # f I _t I I I _ • a /F WN It W, •1 <br />�rryaltAPTATIj2(/IT.SI 'i s i - • I =21 <br />���% • ryayG', <br />lI 1 11�/,I _.7-11111111 aMAMN <br />/ Il 1 MIU 7f179Z:i:�JI_ '7 =l <br />U OT12911e <br />