Laserfiche WebLink
01-04-' 10 11:04 I HUM- T-380 F001/001 F-970 <br /> DAT C I ED • EHD LOG NUMBER <br /> � ; SAN JOAQUIN COUNTY <br /> I�1] L'-� �� L= ENVIRONMENTAL HEALTH DF.PARTMENT <br /> 5 . 600 East Main SteStockton, 02-3029 <br /> .i�s� 4 201.0 �-_ <br /> Telephone: (209) 468-3420 Fa'x: (209 ) eb:www.sjgov.or"dp <br /> ENVIRONNIE-N1 HEALTH PUBLIC RECOR � � E APPLICATION <br /> PE ._ <br /> APPLICANT: Elizabeth Emmons >� t311SINtSlAGENt;Y: Geological Technics Inc. <br /> ADDRESS: 1172 Kansas Avenue R`CIT1(/S ATE/ZIP: Modesto, CA 95351 <br /> PHONE(1): 209-522-4119 PHONE(2); FACSIMILE: 209-522-4227 <br /> TENr"AC/VE*APPOINTMENT DATE: Monday, ,Ian 11, 2010 Time: 10 AM <br /> (Please allow 10 business days from date of application submittal-'Tentative only-must be confirmed) <br /> CHECK BOX TO EXPEDITER QUEST-$115 FEE(GASH OR GHEGK ONLY)-REQUEST PROCESSED IN 3 B SINESS DAYS <br /> SIGNATURE OF APPLICAN `zc��?e ��� DATE jZ;�/v <br /> Electronic Information: ❑List❑ Map-description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City 171 Unit 1 <br /> 1. 15000 Schulte Road Tracy <br /> 14700 Schulte Road TracyB <br /> r -'! 21, it 2 <br /> 3. <br /> 4. ni „ <br /> 5. <br /> 6. <br /> ��nftA <br /> 7. _ <br /> ❑Unit 5 <br /> 10. <br /> Spocific Date Range of Information Requested. From All dates available to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ®SOLID WASTE FACILITYfVEHICLE <br /> 0 OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> [2 UNDERGROUND TANK(MON ITORING/RFMOVAL) ❑DOG KENNEL DAIRY <br /> ®.HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH WASTEWATER TREATMENT PLANT <br /> [-]TIERED PERMITTED FACILITY ❑MOTELIHOTEL PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY [A OTHER(PLEASE SPECIFY) SWEEPS Data <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 5:00 AM-B:OOPM(EXCLUDING HOLIDAYS) <br /> 1. Ljst 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(209)464.0136 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 END files exist. An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The flies 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 /> S. If you need further assistance,please contact Diane Martinez,at(209)468.3425. <br /> EHD USE ONLY <br /> EHD 46.06 8127149 <br />