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10-25-'10 01.83 FROM-Geo-�ical Technics � � ,. � ., T-891 P001/001 F-298 <br /> DATE RECEIVED � SAN .rOAQU1N COUNTY EHb Loc NUMBER <br /> p (� [P:DD <br /> ENVIRONMENTAL HEALTH DEPARTMENT 00���jEil� 600 East Main St. Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> j 2 5 LPUBLIC RECORDS RELEASE APPLICATION <br /> E. p8beth BUSINESS/AGENCY: Geological Technics Inc. <br /> ADDRESS: 1172 Kansas Avenue CITY/STATE/ZIP: Modesto, CA 95351 ; <br /> 209-522 -4119 209-522-4227 <br /> PHONE(1): PHONE(2); FACSIMILE; <br /> TENTAT/VE*APPOINTMENT DATE: Time: <br /> (Please allow 10 buslness days from date of application submittal-`Ten(ative only-must be confirmed) <br /> 70 CHECK BOX TO EXPEDITE REQUEST-3('2Z FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT C<'C-Ct' !ry)r� ilV✓] DATE <br /> Electronic Information: []List❑Map-'Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street 0 Street Namo City UntY 7 <br /> 1. 1710 E California Street Escalon <br /> 2, 1702 Jackson Avenue Escalon Unit <br /> 3- 1714' Main Street Escalon <br /> 4• 1405 California Street Escalon o1 Un(t 3 ` <br /> 5. 1436 First Street Escalon <br /> 6. 1855 Jackson Avenue Escalon oZg unit 4 <br /> 7. <br /> 8. <br /> 9. ❑Unit 5 <br /> .10. <br /> Unit 6 <br /> Specific Date Range of Information Requested: From All dates available .to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLtANUP SITE(LOP) ElHOUSING ABATEMENT [9 iOLID WASTE FACII-nYlVEHICLE <br /> rHER CLEANUP SITE(NoN-LOP) ❑FOOD FACILITY <br /> .3 UNDERGROUND TANK(MONITORINGIREMOVAL) El Doc,KENNEL WASTE TIRE <br /> HAZARDOUS WASTE GENERATOR DAIRY <br /> CHICKEN RANCH �WASTEWATER TREATMENT PLANT <br /> ` ` TIERED PERMITTED FACILITY ❑MOTEL/HOTEL <br /> PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOLISPA LAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY 'OOTHER(PLEASE SPECIFY) SWEEPS Data <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 Am-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten 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 type MUST be selected. Fax to(209)464-0136 or mail to the address indicated above Address <br /> ranges will not be accepted-for additional assistance with filo 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 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$I2,Zdeposit prior to review. <br /> 5. If you need further assistance,please contact Diane Martinez,at(209)468-3426. <br /> EHo USE ONLY <br /> P11D 4"S <br /> 8127109 <br />