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06-27-'11 10: 57 FROM-Geological Technics T-359 P0001/0001 F-333 <br /> � ��®T EHD LOG NUMBER <br /> � SAN JOAQUIN COUNTY <br /> JUN Z 7 [011 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202-3029 Wft <br /> Telephone: (209)468-3420 Fax: (209)464.0138 Web: www.sigov.org/ehd <br /> 0 <br /> ENV PERMITESERVICESNTAL HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:Tamorah Bryant/Cher Tonge/Elizabeth Emmons BUSINESS/AGENCY: Geological Technics lne. <br /> ADDRESS: 1172 Kansas Avenue CITY/STATE/ZIP; Modesco, CA 95351 <br /> PHONE(1): (209) 522-4119 PHONE(2): FACSIMILE: (2o9D 522-4227 <br /> TENTATIVE"APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal. Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$122 FEE(CASH OR CHECK ONLY)-REQUEST PROGESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT rdP'41 2f Yllq DATE L0'a-7 f <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> street 4 Street Name City Unit 1 <br /> 1. 230 Industrial Avenue g Ripon <br /> 2. 850 N Milego Avenue J!� Ripon <br /> 3 Unit 2 16520 E Milego Avenue Ripon I <br /> 16197 <br /> r(, E Milego Avenue Ripon <br /> Unita <br /> 5 18791 E Milego Avenue Ripon <br /> 6. 16790 Milego Avenue Ripon <br /> Unit 4 <br /> 7. <br /> 8. <br /> .__._ ❑unit <br /> 9. <br /> 10. <br /> ❑Unit 6 <br /> Specific Data Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> .®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILI7YIVEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> ENNUERGROUND TANK(MONITORINGIREMOvAL) ❑Doe KENNEL ❑DAIRY <br /> OHA7ARDOUS WASTE GENERATOR ❑CHICKEN RANCH ©WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKNARDICHEMICAL TOILETS <br /> ❑TATTOO/BODY PIERCING ❑POOUSPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICALWASTE FACILITY OTHER(PLEASE SPECIFY) �ShL)Qp�!�I <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS <br /> 1. List up to len 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 typo MUST be selected. Fax to(209)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 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 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 /> ENO USE ONLY <br /> END fleas <br /> 07fTe/10 <br />