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10-24-'11 13:15 FROM-Geological Technics T-519 F0001/0001 F-881 <br /> T ED 0 SAN JOAQUIN.000NTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT 8� <br /> OCT 24 2011 600 East Main St. Stockton, CA 95202-3029 (� <br /> TeleRhone: (209) 468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd ��// <br /> FNVIHONMENTALHEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> i P <br /> APPLICANT:Cher Tonga/Elizabeth Emmons/Jenny Weese BUSINESS/AGENCY: Geological Technics Inc. <br /> ADDRESS: 1172 Kansas Avenue CITY/STATEIZIP: Modesto, CA 95351 <br /> PHONE(1): (209) 522-11119 PHONE(2): FACSIMILE: (209) 522-4227 <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-*Tonfavve only-must bo confirmed) <br /> Q CHECK BOX TO EXPEDITE REQUEST-$122 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: [:]List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑Unit 1 <br /> �- 1691 Frewert Road Lathrop <br /> 2 1601 W Frewert Road (AKA Frewart) Lathrop unit? <br /> . <br /> 4. Unita <br /> 5. <br /> 6. unit4 <br /> 7. <br /> 0. Unit 6 <br /> 9. <br /> 10. ❑Unl <br /> Specific Date Range of Information RegvesWd! From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK[LIST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITYNEHICLE <br /> POTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> U6NDERGROUND TANK(MONITORINGIREMOVAL) ❑DOGKENNEL [_1 DAIRY <br /> 8'HAZARDOU$WASTE GENERATOR ❑CHICKEN RANCH ❑WA$rEWATERTREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKNARDICHEMICAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOLISPA _J. <br /> yAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY IROTHER(PLEASE SPECIFY) (51V3 -8Q5,/'�Y`"CI`�BhCG� <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8: 0AM-5:00PM(EXCLUNNO HOLIDAYS) <br /> 1. List un to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(os). At least one file type MOST be selected. Fax to(289)4e4-0138 or mail tc 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 ten(10) <br /> days after receipt of application. The files will behold 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 be <br /> submitted when the file is available. <br /> 4. Any file not returned in the same condition as released will he 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 /> EHO USE ONLY <br /> ID <br /> EHD48-06 07,29,10 <br />