Laserfiche WebLink
DATERECEIVEDc .� EHD LOG NUMBER <br /> RECEIVED SAN JOAQUIN COUNTY 0 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> { <br /> 30 2011 600 East Main St. Stockton, CA 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd M <br /> ENVIRONMENTAL HEALTH PUBLIC R ., D E APPLICATION <br /> 1 � Py�a- <br /> APPLICANT: Ally Colavita ask B INESS/AGENCY: Advanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP: Stockton/CA/95215 <br /> PHONE (1): 209-467-1006 PHONE(2): 209-483-3401 FACSIMILE: 209-467-1118 <br /> TENTATIVE"APPOINTMENT DATE: ASAP Time: <br /> 52 <br /> / (Please allow 10 business days from date of application submittal-'Tentative only-must be confirmed) <br /> 52 CHECK BOX TO EXPEDITE REQUEESST/--$122 FEE(WV OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT at t -It DATE 3 N <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street 0 Street Name City U it 1 <br /> D� 1. 535 C"Ir-et PSFvcklP,1 Ll <br /> 2. 3tr2$ NO /�JO�/Jf nit2 /�I <br /> 4. -- DLJ <br /> S. 6G1 IJodb Novo( Her 11 <br /> 6. LG5 ,< ., GJT t)e/ I /11 4 <br /> T. 3;L00IV a w+o h Kd( NZ LM-IA cV0, ND to rW <br /> 8• 3 3oo '' ❑Unit 6 <br /> 9. 343 <br /> to. <br /> unne <br /> Specific Date Range of Information Requested: From All to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ®SOLID WASTE FACILrfYNEHICLE hie <br /> L]OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY (]WASTE TIRE I 1 ' -il/ <br /> ®UNDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL ❑DAIRY G�oil �- <br /> ®HAZARDOUS WASTE GENERATOR�i( ❑CHICKEN RANCH ®WASTEWATER TREATMENT PLANT 1IFF//'�1� <br /> ®TIERED PERMITTED FACILITY n' ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILeTS I I <br /> ElTATTOOIBODY PIERCING ElPOOLISPA [:]LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List u0 to ten 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(2091464-0138 or mail to the address indicated 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 EHD staff may not 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 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 /> EHD USE ONLY <br /> -11LDM I 9LI335 05a% �` <br /> 00 K� } <br /> END 40-06 OT122MO <br />