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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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EHD Program Facility Records by Street Name
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BENJAMIN HOLT
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3011
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2900 - Site Mitigation Program
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PR0530063
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
2/6/2019 3:55:34 PM
Creation date
2/6/2019 3:42:59 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0530063
PE
2957
FACILITY_ID
FA0019769
FACILITY_NAME
FORMER SHELL GAS STATION
STREET_NUMBER
3011
Direction
W
STREET_NAME
BENJAMIN HOLT
STREET_TYPE
DR
City
STOCKTON
Zip
95219
APN
10018010
CURRENT_STATUS
01
SITE_LOCATION
3011 W BENJAMIN HOLT DR
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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08/07/2003 13:04 925283612E AEI CONSULTANTS (SF) PAGE 01/01 <br /> _ moo,uv�uoa l n:za 464013F� ENVIRONMENTAL Hd& <br /> Jvn,cnwu•.,. POGO an <br /> ti SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL. HEALTH OEPARTM1 N7l <br /> I� ]y 304 EAST WEBER AVENUE,THIRD FLOOD (h/ <br /> STOCKTON CA 95202 <br /> l FI (209)468.3420 - <br /> S PUBLIC RECORDS RELEASE APPI-6grfvly _ <br /> y� APPLICANT A -BUSINESS/AGENCY- 7't . <br /> �A ADDRESS In�tS I - <br /> PHONE 2-5 --,�;FACSIMILE <br /> �_�1�_f <br /> TENTATIVE"APPOINTMENT DATE_ V)_)'le s( ill <br /> TIME �f <br /> �- (Pleaha gyve t eo 10 buainos days from date of appGcgtion cubm)ttap�� <br /> rim CHECK BOX TO EXPEDITE REQUEST-589.00 FEE-REQUEST PROCESSED INS BUSINESS DAYS <br /> 4K-SIGNATURE OF APPLICANT DATE 3 <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> - PROGRAM ELEMENT$SEARCH <br /> 7111-1 iv -a 'S. j. <br /> (/ e, ILF <br /> 2°o in 1} f o <br /> Ck-w Y) 5 <br /> n r-- <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> X UNDERGROUND TANK(UST)CLEANUP SITE(LOP)'S�HOUSING ABATEMENT A SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE;NON-LOP) ❑ FOOD FAMLITY SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR Q CHICKEN RANCH " PKG TREATMENT PLANT <br /> TIERED PQRMH ED FACILITY �MOT ELMOTEL ❑ PUMPER TRUCKIYARD=EM TOILETS <br /> ❑ TATTOOBODYPEIRCING ❑ POOLISPA X LAND USE APPLICATION SrrEs <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFY)- <br /> 1. List up to ten addresses in the space above. Select the types) of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Pax to (209)464.0138 Or mail to the <br /> address indicated above. <br /> 2. EHD will notify the appllcant if any EHD files wrist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten (I D)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 ava)labie, <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense <br /> of the applicant Future file reviews by the some applicant may require a$89,00 deposit prior to review. <br /> S. "TENTATIVE appointment dates must be confirmed with EHP staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> -CONFIRMED APPOINTMENT DATE TIME <br /> ,DATE CONI IRMED PHONE PAX INTCIALS <br /> REVIEWED YES No REVIEW DATE <br /> 6—M 4842:5oc <br /> 7I[u2oos <br />
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