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Jan, 2S, 2011 11 -V 0! IN CHLOR ALKALI PRODUCTS <br /> 1743 F. 1 <br /> DATE RECEIVED <br /> RECEIVEDto 10 <br /> SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> N41 <br /> 600 Fast Main St. Stockton, CA 95202-302954 62 <br /> ..A 2 8 20�� Telephone: (209) 468-3420 Fax: 209 4640138 Web' <br /> ( ) . www,sjgov.org/ehd <br /> ENVIRn�FnITAI HFAUTH PUBLIC RECORDS RELEASE APPLICATION <br /> PERMIT/SERVICES "—' —� <br /> APPLICANT: Elizabeth Muse Pioneer Americas , LLC <br /> _BUSINESS/AGENCY;-dba Ol 1 nLijur—Al kali Poduct� <br /> ADDRESS; 26700 S . Banta Road CITY/STATE/ZIP: Tracy, CA 95304 <br /> PHONE(1): 209-221 -8206 PHONE (2): FACSIMILE:209-835-5445 <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from 0919 01 application submittal•'Tentative only•must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$1 2 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 9USINESS DAYS <br /> SIGNATURE OF APPLICANT DATE Jho $1 <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City <br /> unit 1 <br /> S Banta ' ► ``.j <br /> 2. <br /> O Unit 2 <br /> 4. <br /> El Unit 3 <br /> 5. <br /> 6. <br /> Unit 4 <br /> 7. <br /> 8, <br /> Unit 5 <br /> 8, <br /> 10. <br /> D unit s <br /> Specific Date Range of Information Requeet9d: From ��}}�� 1 to <br /> ENVIRONMI NTA TH MARTI L S J� <br /> ❑UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE I ACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY Q WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL <br /> ElIIAZARDOUS WASTE GENERATOR ❑DAIRY <br /> El RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTELMOTEL <br /> ❑TAT70OI80DY PIERCING ❑PUMPC•R TRUCKIYARD/CHEMICAL TOILETS <br /> ❑POOLISPA ❑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:OOPM(EXCLUDING HOLIDAYS) <br /> 1. 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 file type MUST be selected. Fax to(208)464.013a 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 EHO 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 flue 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 he reorganized by EHD staff at the expense of the applicant. <br /> Future file reviews by the some applicant may require a$122 deposit prior to review. <br /> tSHo USE ONLY <br /> Elio 4B.of! <br /> oT129110 <br />