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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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4 (STATE ROUTE 4)
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14210
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2900 - Site Mitigation Program
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PR0508457
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COMPLIANCE INFO
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Last modified
11/20/2024 9:09:14 AM
Creation date
2/18/2020 9:57:42 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0508457
PE
2960
FACILITY_ID
FA0008088
FACILITY_NAME
HERB SPECKMAN FARMS
STREET_NUMBER
14210
Direction
W
STREET_NAME
STATE ROUTE 4
City
STOCKTON
Zip
95234
APN
13112004
CURRENT_STATUS
01
SITE_LOCATION
14210 W HWY 4
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\sballwahn
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EHD - Public
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Lori Duncan [EH] <br /> From: Lori Duncan [EH] <br /> Sent: Wednesday, May 06, 2009 4:27 PM <br /> To: 'nvolpi@sbcglobal.net' <br /> Subject: Permit forms <br /> Attachments: Scanned_.pdf <br /> Scanned_.pdf(314 <br /> KB) <br /> Hi Nancee, <br /> Here are the different forms we need for the permit. I checked our file for your site and <br /> the Master File Record form (MFR) that we currently have lists AGE as the billing party, <br /> so we will need a new MFR for me to be able to process the permit. It is the first form <br /> in the attachment. You do not need to fill it out in great detail, no SSN's or driver <br /> licenses for example, just the basic information to identify the site and to be able to <br /> get in touch with you, and it must be signed at the bottom. <br /> The next two pages are the drilling permit. The driller should sign the permit, and they <br /> must fill out the last page called Licensed Contractors Declaration which verifies that <br /> they have the proper license and insurance. <br /> Please call or write if this is not clear or if you have any further questions ! <br /> Lori <br /> Lori Duncan, Senior REHS <br /> San Joaquin County <br /> Environmental Health Department <br /> lduncan@sjcehd.com <br /> (209) 468-0337 phone <br /> (209) 468-3433 fax <br /> 1 <br />
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