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SITE INFORMATION AND CORRESPONDENCE_FILE 1
Environmental Health - Public
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EHD Program Facility Records by Street Name
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6633
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2900 - Site Mitigation Program
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PR0528433
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SITE INFORMATION AND CORRESPONDENCE_FILE 1
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Last modified
4/3/2020 2:46:38 PM
Creation date
4/3/2020 2:30:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
FILE 1
RECORD_ID
PR0528433
PE
2957
FACILITY_ID
FA0019174
FACILITY_NAME
CHEVRON SERVICE STATION 9-6171
STREET_NUMBER
6633
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
09741048
CURRENT_STATUS
02
SITE_LOCATION
6633 PACIFIC AVE
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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0EMWE t'-?/ <br /> �"` �H1�4oc:uu*luG�l <br /> SAN JOAQUIN COUNTYP'UBLIC HEALTH SERVICES <br /> JAI 0.2 2007 ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST'Wiw191=Iti AVZN'UC,THIRD FLOOR <br /> ENVIRONMENT HEALTH STOCKTON CA 95202 <br /> PERMIT/SERVICES (209) 463-3420 Z(o74/ <br /> PUBLIC RECOPW RFLEABF— APPLICATION <br /> APPLICANT c` r'iz dy GUSINESSIAGENCY UY1�V ti " <br /> � 9 9 <br /> ADDRESS � 1 <br /> `PRONr Z FACSitAILL q7�S <br /> TENTATIVE,APPOINTMENT DATE i 1 �a-7 TIME 910of' ' <br /> (Pica:- givo 7 to 10 bUSIonkis dsys Item onto of appllcaUvn.ubmllini) <br /> CHECK Dox Tp cxp5nmiz RGOUE�VT•$09.00 FEE—RCpttI:ST PROCESSED IN a BUSINESS DAYS <br /> *SIGNATURE OF APPLICANT _4r DATE <br /> FELE ADDRVS$ THIS SINE Elia ST AFK US12 qLy <br /> PROGRAM ELEMENTS SCAR H <br /> 5 I � IY1 1./n✓ r ;I <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> 5/ NOERGROUHb TANK(U51)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT W SOLID WASTE FAC <br /> L$' T�rR Ct,EnNUP SITE(NON-LOP) ❑ FDOU FACILITY D SOLID WASTE VEHICLE <br /> R`'�Tj�IJOERG>xOUF20 TANK(M0t11TaRIKGlE2) SM1OV/U I Cl DOG KENNEL- 0 DAIRY <br /> WHAZARMLIS WASTE GENERATOR CHICKEN RJWCN f� ru TREATMENT ARDPLAI't <br /> =RED PERMMED FACILITY C1 MOTEUHOTEL � DANDER C APPLICATION <br /> SIT rO�I I-s <br /> t7 TAT'TOOMODY PEIRCING Ct POOUSP'A a OTHLANER <br /> USP:EASFI5ATidN Saes <br /> D MEDICAL WASTE FACILITY A I�THER(i'I Et156 SPCCIFY AI30VE) <br /> 1. Ust up to tan addressas In the Spa= above. Select the type(s) of files from the list above by checking <br /> the appropriate boix(es). At least onu file type MUST be selected. Fax to (209)464.0138 or Inai) tO.the <br /> aiddrass indicated above. <br /> 2, EHD will notify the appficartf if any FHd files exist. An appointment for ruview will be confirmed <br /> approximately five business days but no latorthan ton.(10)days aershou dpli scheduled on, The riles les <br /> will be hold for a maximum of five buslnuSS days for review. Appointment-, <br /> accordingly. <br /> 3, A file lhat,l5,actively baing worked on by EHO staff may not be immediately available For review. Anew <br /> applic.atlon may be.submitted when the fiila is avallable. <br /> 4. Any flla not returned in the same condition as releasad will be roorganlzed by ErHD staff at the exponsc <br /> of the applicant. Future file raviows by the same applicant may require a $89.00 dop❑sit prior to review. <br /> g_ *TE=NTATIVE appointment dates must be confirmed with EHD Staff. <br /> 6, Appiiaations received after 3-OD pm will be processed the next business day- <br /> CONFIRMED APPOINTMENT DATE, TIME <br /> nATI_CONFIRMED ___ PHONE FAY, INITIALS <br /> REVIEWED YET NO REVIEW DA'T'A <br /> 1.nnr T� <br /> ZO 39VJ LV8Z86L0LEL 29:60 L00Z/60/10 <br />
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