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01-14-'13 14:06 FROM-Geol((cQi��cal Technics - <br /> DATERECEIVED T-879 ..P9001/0001 F-338 <br /> �1 ' <br /> SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> � q ENVIRONMENTAL HEALTH DEPARTMENT 0 <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> PN �Wyphone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> J <br /> y �'tS'UBLIC RECORDS RELEASE APPLICATION 1% <br /> APP�y� Wnny Weese BUSINESS/AGENCY: Geological Technics <br /> ADDRESS: 1172 Kansas Avenue CITYISTATE/ZIP: Modesto, CA 95351 <br /> PHONE(1): 209-522-4119 PHONE(2): FACSIMILE: 209-522-4227 <br /> TEtVTA TIVE'APPOI NTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-'Tentative only-must be confirmed) <br /> ❑CHECK SOXTO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 B SIN SS DAYS <br /> SIGNATURE OF APPLICANT �Q `9�' t`' DATE t 1`I )3 <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS END USE ONLY F <br /> Street p Street Name City ❑Unit 1 <br /> 1. 20001 McHenry Avenue S'. Escalon , I <br /> 2. 19901 McHenry Avenue Escalon ❑Unit z <br /> 3. 2RSU 2RS3 <br /> 4. <br /> EI Unit 3 <br /> Re- <br /> 6• + / Pj`Unit4 <br /> 7. <br /> ❑Unit S <br /> 9. <br /> 10. ❑Unit 8 <br /> Specific Date Range of information Requested: From to - <br /> ENVIRONMENTAL HEALTH DEPARTMENTFILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACIUTYIVEHICLE <br /> to OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT [:1 WASTE TIRE <br /> ®UNDERGROUND TANK(MONITORINGIREMOvAL) ❑FOOD FACILITY ❑DAIRY <br /> ®ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> [.HAZARDOUS WASTEMATARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARD/CHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOUSPA ❑LAND USE APPLICATION SITES <br /> ❑TATToo190DY PIERCING ❑COMPLAINTIRESPONSE RECORDS [A OTHER(PLEASE SPECIFY) �� S <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAY <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)484.0138 or mall to the address indicated above,. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the END. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The END will notify the applicant if any END 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 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 reorganized by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. <br /> NONE. ME1 <br /> END 46.06 - 914112 <br /> Received Time Jan. 14. 2013 2: 08PM No. 2101 ,r- <br />