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01p-r-0p4-' 10 111:04 I1HUM- T-380 P001/001 F-979 <br /> ;1!/E " SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL TH D ARTMENT <br /> �arj 4 2010 600 East Main St k(on;, 02-3029 <br /> Telephone: (209)468-3420 Fax (20 eb:www.sjgov.org! dqP <br /> ENVIRONMENT HEALTH PUBLIC RECOR <br /> PE PLICATION <br /> Elizabeth Emmons <br /> APPLICANT: RUSINk CY: Geological Technics Inc. <br /> ADDRESS: 1172 Kansas Avenue CITY/STATEIZIP: Modesto, CA 95351 <br /> PHONE(1): 209-522-4119 PHONE(2); FACSIMILE: 209-522-4227 <br /> TENTATIVE"APPOINTMENT DATE: Monday, Jan 11, 2010 Time: 10 AM <br /> tf�� <br /> (Please allow 10 business days from dato of application submittal-'Tentaovo only-must be confirmed) <br /> n CHECK EIOX TO EXPEDITER QVEST-$115 FEE(GASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 a INESS DAYS <br /> SIGNATURE OF APPLICANT t k,\,,0ijUjA,, �/r wv� DATE S <br /> Electronic Information: ❑List❑Map-Description: <br /> FILE ADDRESS LHD USE ONLY <br /> Strsat k Street Name City Unit t <br /> 1. 15000 Schulte Road Tracy GA; NU` irtv,r• r, <br /> 2, 14700 Schulte Road Tracy <br /> 3. ! <br /> 4. <br /> 5 nit 3 <br /> 6. <br /> T nit 4 <br /> 9 ❑unit s <br /> 10. <br /> Unit 6 <br /> Specific Dale Range of Information Requnsted: From A 1 dates available to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES - �fC�S �� <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT Ej SOLID WASTE FACILITYlVEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE J <br /> ®UNDERGROUND TANK(MONITORINGIREMOVAL)V,, C]DOG KENNEL DAIRY <br /> HAYARDOUS WASTE GENERATOR�, ❑CHICKEN RANCH WASTEWATER TREATMENT PLANT )-j-'0 <br /> ❑TIERED PERMITTED FACILITY ❑MOTELIHOTEL PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATTOO/BODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY [�OTHER(PLEASE SPECIFY) SWEEPS Data <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 5:00 Am-15:00PM(EXCLUDING HOLIDAYS) <br /> t. List up 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 Nle type MUST be selected. Fax to(209)464.0138 or mail to the address indicated above Address <br /> ranges will not be accepted-for additional assistance with Nle 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 ton(10) <br /> days after receipt of application. The tiles 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 he <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$115 deposit prior to review. <br /> 5. If you need further assistance,please contact Diane Martinez,at(209)468-3425. <br /> END USE ONLY <br /> tiot2f1p�4'dj V/4 <br /> END 4e-0e 16 <br /> 8117!09 <br />