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SITE INFORMATION AND CORRESPONDENCE_CASE 1
EnvironmentalHealth
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SITE INFORMATION AND CORRESPONDENCE_CASE 1
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Last modified
3/6/2020 3:55:16 PM
Creation date
3/6/2020 2:59:13 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
CASE 1
RECORD_ID
PR0506313
PE
2950
FACILITY_ID
FA0000514
FACILITY_NAME
MAIN STREET SHELL*
STREET_NUMBER
1071
Direction
N
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
APN
21707011
CURRENT_STATUS
02
SITE_LOCATION
1071 N MAIN ST
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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07/10/00 MOW 16:10 FAX 209 94 62 - �,a S,�4iiANih'fti'lU µ:Jl3U1 <br /> .1 <br /> . _ cinri rraa TO 1'ex7?4294162 PA32 <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> AUG 2 9 2000 304 EAST WEBER AVENUE,THIRD R-OOR -` <br /> STOCKTON CA 95202 <br /> ENVIRONMENT H LTH (209)4U-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> T BUSIN"SIADENCY <br /> >. .4 V i <br /> 0 FACSIMILE t 3 �=' <br /> T'ENTATIVE'APPOINTMENT DATE <br /> (Please gkee T to 10 busin"s daya from data of appMwdon s0nnWatl <br /> CHECK Sox TO EXPEDITE REQU -578-00 -RE EST PROCESSED IN 3 BUSMESB'RAYS <br /> SIGNATURE OF APPLICANT DATE <br /> FILE ADDRESS <br /> Z 2` <br /> -� <br /> ENVIRONMENTAL HEALTH OMSION FILES <br /> uNDEROROUND TANK(UST)CLEANUP SITE IL.OP) a HOUSING ABATEMENT Vj SOUD WA9TC FACILITY <br /> OTHER CLEANUP siTE(NON-LOP) a FOOD FACILITY ❑ SoL1D WAWM VEHICLE <br /> 14 uNDERGROUND TANK(MONITORINGMEMOVAL) O POO KENNEL DAIRY <br /> CHCKEH RANCH �( PKG TRHATMENT PLANT <br /> HAZARDOUS WASTE GENERATOR Q 9AOTELIHOTEL PUMPER TxwI;wVARDiCHEY TOILETS <br /> �l TIERED FERMI-fTED FACILITY O pOWSPA LAND USE APPLICATION SIT68 <br /> O TATTOO/1300Y PEIRCINtiO PUBLIC WATER SYSTEM D OTHER(PLOASE SPECIFY ABOVE) <br /> t3 MEDICAL WASTE FAC;UT1r <br /> 11- List up to ten addmvws in the space above. Select the type(s)of fOt es from the list above by checking <br /> the appropriate box(ez). At learot ono file type MUST be selactild. <br /> III to t" <br /> addr 1j.S Indiratyd above, <br /> 2. EHD will notify the applicant if any EHO files euist. An appointment for roviaw will be con infned <br /> approximately five business days but no later than ten('SO)days after receipt of application. The files <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review- A new <br /> application may be submitted when the file is available. <br /> 4. Any fide not retumsd in the same condition as released will be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require n$78.00 deposit prior to review_ 4 <br /> 5_ "'TENTATIVE appointtnant date& must be confirmed with EHD staff. J <br /> 6. Applications recaivted after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE. TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> GN oo . of <br /> TOTAL P-02 <br />
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