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01/28/2008 09:02 209522 GECLCGICAL TECH PAGE 02/02 <br /> EHD LOG NUM®ER <br /> ��� °,� SAN Ja: puzivCOUNTY <br /> ENVZRaNMENTAil,HEALTH DEPARTMENT <br /> tdn 600 East Main St�rek, Stockton, CA.95202-3029 <br /> yy - Telephone:(209)466-3420 Fa1 .(209)464-0138 Web,www.sj / <br /> PUBLIC RECORD88'IRELE SE APPLICATION <br /> APPLICANT: Elizabeth FmmonG BUSINESSIAGENCY: Geological Technics Inc. <br /> ADDRESS: 1101 7th St et Modesto CA 95354 <br /> PHONE(1):C209)522.4119 PHONE(2):_, FACSIMILE: (209)522-4227 <br /> TENTATIVE*APPOINTMENT DATE; ; Tlmg: <br /> {Please allow 10 buslnars days from date of a '1 Ijeatlon submittal-"Tentative only-must be confirmed) <br /> V CHECK BOX TO EXPEDITE REQUEST-$98-00 FEE tC4liiH OR CHECK ONLY)-REQUEST PROCESSED rN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT _ DATE <br /> X Electronic Information: d List❑Map—Descriptih'ih: +� <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City vko\ 13Unit 1 <br /> 1 1529 Charter Wa W(Halt kprpthers Stoekkon (iL(j d� <br /> . 1541 �) Unit2, <br /> W(tio t Brv_thersl _ Stockton-'no <br /> 3. 1145 Charter Way W(Independent Trucking) Stockton—Orpp rrLl�,�i <br /> Q. 2041 Navy prive(LKO Auto PI�rt3/LIKA Corp) Stockton a2-) unit 3 <br /> '\X <br /> 5. <br /> 6 ' <br /> "It 4 <br /> 7 a <br /> ❑ Linit s <br /> J. <br /> � ff <br /> �� ��z t ❑ unit 6 <br /> ( 10. "Ot✓� Z� <br /> 1� Specific Dake Range Of Information Requested' From to <br /> ENVIRONMENTAL H 'ALTH DEPARTMENT FIL=s <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOU9Ik.i ABATEMENT 0 SOLID WASTE FACILITY/VPHICLE <br /> OTHER CLEANUP SrrE(NON-LOP) Q FOOD 0AiDILITY 11 WASTE TIRE <br /> UNIDEROROUNa TANK(MONITORINGIREMOVAL)✓ 0 DOG KkhNFL 0 DAIRY I <br /> HAZARnous WASTE GENERATOR EI CHICK4!!AANCH 11 WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTr.n FACILITY C7 MOTELiftpOTEL Il PUMPER TRDCK/YARD/CHEM TOtLET9 <br /> O TATTGO/BODY PIERCING 0 POOL ioi..' C1 LAND USE APPLICATION SITES <br /> b MEDICAL wA®TE PACILIT , �0 <br /> Y -OTHER LEASE SPECIFY) <br /> WELLAND SEPTIC PERMIT RECORE)6 ARE AVAILABLE FOR I ,`,41IEW - MCNDAY-FRIDAY 9:00 AM-5:00PM - EXCLUDING HOLIDAYS. <br /> 1. List up to ten addresses In the space above. Select the G 1pe(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected, Fax 209 464-0138 or mail to the address Indicated above. Address <br /> ranges will not be accepted-for additional assistance dIr',Ith file addresses,contact the EHD.Applications received after <br /> 3:00 pm will be processed tha next business day. <br /> 2. The EHD will notify the applicant If any FHD files exist. i„'e appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The files will be held f6k 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 EHD staff may ftt be immediately available for review. A new application may be <br /> submitted when the file is available. <br /> 4. Any file not returned in the same condition as released v0ii he reorganized by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a 048.00 deposit prior to review. <br /> EHV 1lJSE ONLY <br /> 1 L fz 040, v <br /> FM-4e-0e wee 9 812007 - <br />