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06-27-'11 10:57 FROM -Geological Technics <br />T-359 P0001/0001 F-333 <br />RWNED — EHD LOG NUMBER <br />SAN .IOAQUIN COUNTY <br />JUN 2 7 1011 ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main St. Stockton, CA 95202-3029 <br />Telephone; (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />ENVIRONMENTALERMISRVICESLTH PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT:Tamorah Bryant/CIIer Tonge/Elizabeth Emmons BUSINESSIAGENCY:Geological Technics Inc. <br />"'ADDRESS: 1172 xanaae Avenue CITY/STATE/ZIP: Modesto, CA 95351 <br />PHONE(1): (209) 522-4119 PHONE (2)- FACSIMILE: (2090 522-4227 <br />TENTATIVE* APPOINTMENT DATE: Time: <br />(Please allow 10 business days from date of application submittal •'TentatiV0 only -must be confirmed) <br />❑ CHECK BOX TO EXPEDITE REQUEST - $122 FEE (CASH OR CHECK ONLY) - REQUFST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT Q CLAZ hl 2('Y)PT'1- , DATE IDI J-7 jI ( <br />9Z <br />Electronic Information: ❑ List ❑ Map- Description: <br />ffl 11244 a/ • -1 I e t / <br />• z / <br />■i <br />FILE ADDRESS <br />,. ♦ •..i r� <br />EHD USE ONLY <br />Unit 1 <br />Unit 2 <br />Street Yl <br />Street Name <br />City <br />1- 230 <br />Industrial Avenue <br />Ripon <br />2, 650 <br />N Milego Avenue <br />3 <br />165?0 <br />E Mil0go Avenue <br />Ripon <br />3 Nb io�q <br />Unit 3 <br />4 16197 <br />E Mil9go Avenue <br />Ripon p <br />5. <br />16791 <br />E M11490 Avenue <br />Mil�5'90 Avenue <br />Ripon <br />Ripon <br />.e �' <br />Unit b <br />6. 16790 <br />7. <br />❑ Unit 5 <br />S. <br />9. <br />❑ Unit 6 <br />10. <br />SpeealC Date Range of Information Requested: From to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES T C <br />KI UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT ❑SOLID WASTE FAGILRYNEHICLE �' " ID S • ✓! <br />OTHER CLEANUP SITE (NON -LOP) ❑ FOOO FACILITY ❑ WASTE TIRE <br />UNDERGROUND TANK (MONITORINGIREMOVAL)46 <br />❑DOO KENNEL ❑DAIRY <br />HAZARDOUS WASTE GENERATOR Of [❑ CHICKEN RANCH ❑ WASTEWATER TREATMENT PLANT <br />❑ TIERED PERMITTED FACILITY,( ❑ MOTEL/HOTEL ❑ PUMPER TRUCKIYARD/CHEMICAL TOILETS <br />❑ TATTOO/BODY PIERCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br />❑ MEDICALWASTEFACILITY 00THER(PLEASE SPECIFY) [5I. UP!,71 eyYILV'�QY1Ct� a-�y •�� <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 5:00 AM-5:00PM (EXCLUDING DAYS) <br />I. List up to tan 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 (20s) 464.0138 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 EHD files exist. An appointment for review will be confirmed approximately ton (10) <br />days after receipt of application. The files 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 END staff may not be immediately available for review. A new application may be <br />submitted when the file is available. <br />b. 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 $122 deposit prior to review. <br />sun ues nut v <br />aAmotl.i.Ti <br />ffl 11244 a/ • -1 I e t / <br />• z / <br />■i <br />�ili <br />,. ♦ •..i r� <br />it 4�iil //,/ . �a •_ / a s u I/! 7EZ:�•I!'7.. <br />�/ a i <br />` <br />V -orrzalto <br />