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06-27-' 11 10: 57 FROM-Geological Technir_s T-359 P0001/0001 F-333 <br /> � <br /> EHD LOG NUMBER <br /> REGE �r �-D SAN JOAQUIN COUNTY A <br /> JUN 2 7 [p(j ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202.3029 /✓� <br /> Telephone; (209)468-3420 Fax: (209)464-0138 Web; www.sjgov.org/ehd <br /> ENVPERMITSERVIC ENTAL SETH PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:Tamorah Bryant/Cher Tonge/Elizabeth Emmons BUSINESSIAGENCY: Geological Technics Inc. <br /> 'ADDRESS: 1_1i2 Kansaa Avenue CITY/STATEIZIP: Modesto, CA 95351 <br /> PHONE(1): (209) 522-4119 PHONE(2): FACSIMILE: (2090 522-3227 <br /> TENTATIVE"APPOINTMENT DATE: Time: <br /> (Please Dow 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 PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT cG <LeP ) j IO JN—III DATE LO)0-1 /I <br /> Electronic Information: ❑List❑ Map—Description: <br /> FILE ADDRESS EMD USE ONLY <br /> ^/ Street it Street Name City _❑Unit i � <br /> 230 Industrial Avenue Ripon !� I ( Lv W91 ) <br /> 2 850 91 Mil)fgo Avenue Ripon Unite <br /> 3 16520 E Milrigo Avenue Ripon ; N:, (.O19 <br /> 4 16197 E Milego Avenue Ripon <br /> p Unit 3 <br /> 5. 16791 E Miligo Avenue Ripon © �I <br /> 6, 16790 Milogo Avenue Ri on / <br /> P C unil4 <br /> T. <br /> 6. <br /> ❑Unit 5 <br /> 9. <br /> 10. <br /> ❑ <br /> Unit 6 <br /> Specific Date Range of Infe mation Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> KI UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLIDWASTEFACILITYIVEHICLE o P6!— <br /> OTHER CLEANUP SITE(NON-LOP) El FOOD FACILITY ❑WASTE TIRE ��� <br /> ETUNDERGROUND TANK(MONITORING/REMOVAL)V_ ❑Doe KENNEL ©DAIRY <br /> HAZARDOUS WASTE GENERATOR Of ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT 7" 1-d <br /> ❑TtEREO PERMITTED FACILITY d ❑MOTELIHOTEL ❑PUMPER TRUCK/YARD/CHEMICAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICALWASTE FACILITY 10 OTHER(PLEASE SPECIFY)[ Qp.p!�12 m&Y'61Qr1Cts <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOUDAYs <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(2091464-0138 or mail to the address indicated above Address <br /> ranges will not be accepted-for additional assistance with Ole 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 some applicant may require a$122 deposit prior to review. <br /> EHD USE ONLY <br /> -1 a e <br /> tr <br /> E D -06 OT129/10 <br />