Laserfiche WebLink
10/2212010 08:46 9257466099 AE1 CONSULTANTS PAGE 01101 <br /> r 0 SAN JOAQUIN COUNTY EHE)LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> w-.12 2 2010 600 East Main St.Stockton, CA 95202-3029 <br /> ENVIRUNNIEN .HEA P"One: (209)468-3420 Fax. (209)464-0138 Web:www.sjgov. rgleh <br /> PFR <br /> ' E- nn P_UB1-IC�EC-ORDS ]E--L-EA SEEP -ICATiON IF <br /> APPLICANT: <br /> ,,g Cr BUSINESSIAGENCY: <br /> ADDRESS: �cvv QI'YII11b IakAb CITYJSTATEOP: -wo In L) <br /> PHONE(1): �`� {�-fvob PHONE(2): [Q'�5 [o-bbrJ FACSIMILE: (�2 7` r <br /> TENTATIVE*APPOINTMENT DATE; <br /> Time: <br /> (Please allow 10 truslness days from data of aplaPcatian submittal-*TentArFve only-must ba confirmed) <br /> C]CHECK BOX TO EXPEDITE RE ST-$115 FEI C SH OR CHECK ONLY)•REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICAN -( >rin- ��yRk >�-c DATE ( 2-Z O <br /> Electronic Information., ❑hist❑ Map—Description: <br /> f FILE ADDRESS ENE)USE ONLY <br /> Street# Street Name <br /> City <br /> It-1- <br /> 14 . <br /> Tf <br /> 1. 011 <br /> 1Jr` �r��y/rnn} - S13'�r�rx.[/ tTt�n <br /> 2. lf�VJ'1�-'lI lfl� ! 'VrF. <br /> 3. fix. unit 2 <br /> U.S�- 1rTi� S -i f' IC 1 SAF glrf3 �} ��l 1 {03 —/ <br /> a' 6 d �` '�.i" SCK G <br /> ��'_1e7 Unit 3 <br /> 7. /Q Unit 4 <br /> 8 i - <br /> 9. --- ----=CI unite - <br /> 10 <br /> SPecif90 Data Range of Information Rat{vested: From Untt B <br /> ENVIRONMENTAL HEALTHDEPARTM T'FILES <br /> ®LiNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSi o ABATEMENT SOLiD WASTE(•ACILiTYIHEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY WASTE TIRE <br /> UNDLRGRoum TANK(MONITORiNGIREMOVAL) f DOG KENNEL DAIRY <br /> HAZARDOUS WASTE GENERATOR CHICKEN RANCH WASTEWATER TREATMENT PLANT <br /> TIERED PERA3i1TED FACILITY MOTEL/HOTEL iJF{OTEL PumPERTRUCKIYARDICHEmicAL To;LLTS <br /> TATT00lE 6CY PIERCING POOLISPA LAND USE APPLiCAtION SITES <br /> tZ MmIcAL WASTE FACILITY OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REmEww: MONDA -FRIDAY 8:00 AM-5:00PM(EXCLUDiNG HOLIOAYB <br /> i <br /> • <br /> 1,15t PP IQ ten addressed in the space above. Select the types)of files frm the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. F 09 4-0 r m OthgildorAnlallicatetlaboye. Address <br /> E ranges will not be accepted-for additionar assistance with file addressed,contact the END. Applications received after <br /> 3:00 prn will be processed the next business day. <br /> 2. The END will notify the applicant if any END files exist. An appointment f r review will be confirmed approximately ten(10) <br /> days after receipt of application. The files will be held for a maximum of live 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 /> 4. Any file not returned in the same condition as released will be reorganize by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$11S deposit prior to review. <br /> 6. If you need further assistance,please contact Diane Martinez,at(209)46x-3425. <br /> EHD USE 6H4Y <br /> EHt)4s-as <br /> 81z�ros <br /> I <br />