Laserfiche WebLink
10-10-' 16 15: 02 FRO Ground Zero Analysis 209-522-4227 T-348 P0002/0002 F-921 <br /> OATt ECE I V E SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> OCTf 1 ENVIRONMENTAL HEALTH DEPART <br /> i,l 201 : (2 East Hazelton Avenue, Stockton,CA b: <br /> Telephone: (209)468-3420 Fax:(209)464-0138 Web: g g/e <br /> • ENVIRONMENTAL HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: a TL eese BUSINESS/AGENCY:Ground Zero Analysis, Inc . <br /> ADDRESS: 1172 Kansas Avenue CITYISTATEIZIP: n a A <br /> PHONE(1); 209-522-4119 PHONE(2);: 209-402-7396 FAX OR E-MAIL: jweeseegroundzeroanalysiE.com <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an.appointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT \� 1��FiE <br /> CHECK VOX T1 E .PE ITE .EQUEe select <br /> paceh T-$139 (...... ...............CKONLY)•.REQUEST PROCESSED IN 3 BUSINESS DAY$ <br /> DATE 10/10/16 <br /> t Listup to ten addresses in a $tow. Select the types)of files from the list below by checking the appropriate <br /> box(es). At least one file type UST b ed..Fax to f209)464.0138 or mail to the address indicated above. Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance in identifying the nature and cohte nl of EHD records,please contact EHD at the number noted above. <br /> 3. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten(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 /> 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$139 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:0013M(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List[] Map-Description: <br /> Specific Date Range of Information Requested: From to <br /> NVIRONMENTAI{ <br /> )1EALTH DEPARTMENT FILE ADDRESS <br /> ('ILEA EHD USE ONLY <br /> Ejl)L1NDER4ROUNOTANK(UST) Street# Street Name city <br /> • CLEANUPS, 1LaP) r ❑CONIF-1TH <br /> OTHER CLEANUP SITE(NON�OP) t 223 W. 5th Street Ripon Ali'. <br /> F1 HAZARDOUS WASTE C TTL � ^ DAI4Y <br /> ❑TIERED PERMITTED FACWTY 2 201 W. 5th Street Ripon IlA�} R,Er;/.tl 'C,o <br /> E]ABOVEGROUND TANK <br /> MVET (MONITORING/REMOVu) ❑PWS <br /> n HAIARDOUE MAVAULE a o <br /> ❑SPILURELEASE RESPONSE <br /> Ij SOLO WASTE FACILITY/VEHICLE d %V., WATER QVWTY NOON <br /> E]FOOD FACILITY IV <br /> F1 POOL/SPA Ll� El SIZE MITICAnON <br /> DaKv s <br /> L/WD USE APPLICATION SITES <br /> SEPTIC PUMPER TRUCK/ ❑MOUSING <br /> 6 <br /> YARD/CHEMICAL TOILETS <br /> n WASTEWATER TREATMENT PLANT <br /> COPA <br /> Q HOUSING ABATEMENT T <br /> E]MOTEVHDYEL <br /> E]CHICKEN RANCH/DDG KENNEL cup. US, <br /> L]MEDICAL WASTE FACILITY B <br /> F1 TATTOO/800Y PaACING <br /> WASTE TRE ❑SWO WASTE <br /> 9 <br /> COMPLAINT <br /> OTNER(PLEASE SPECIFY). <br /> ACCOUNTING <br /> t0 <br /> -'BOXED AREA.END USE ONLY^' <br /> 0 Records provided by Staff-PPR Complete. staff Namp: <br /> EHD 47 <br /> Received Time Oct. 10. 2016 3 : 06PM N0. 0130 <br />