Laserfiche WebLink
MAY-28-2309 15: 15 Tetra Tech, Inc. 415 974 5914 P.02 <br /> DATE RECEIVED EHD LOG NUMSER <br /> SAN .IOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, $tOCkton, CA 95202-3429 q3 <br /> Teleph ne: (209),468- 0 Fax: (209)4640138 Web:www.sjgov.or <br /> UBLI CORD RELEASE APPLICATION <br /> APPLICANT: n Il71v Q P.L a 6-6—'6-6—' U SUSINES <br /> ' SIAGENCY: <br /> ADDRESS: ��uG GJT l�=,�e "JG Ctty/Stattaip �jt�.Yi f-YD.i1(AE CC S-A <br /> PHONE(1): �� �J J t Z t(RtI PHONE(2): 41-E, C1-1 4 ��Z( ('I'ln/xj k1) FACSIMILE. <br /> TENTATIVE` POINTMENT DATE: 1 1�j Time: (�at Y1 <br /> (Please allow 0 business days from date of appl(catlan submittal-'Tentative only-must be confirm(A) <br /> CHECK BOX TO AXP DITE REQUEST.$ OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICA T BATE 2`3Or <br /> Electronic Information: -j List❑Map-Description: <br /> FILE ADDRESS _ _ -- - ._._..._..—_- EHD USE ONLY . .. <br /> Streets Street Name Ctty _ <br /> z. <br /> it z <br /> 3. 1 <br /> 4 - I Unit <br /> Unit 4 <br /> 5 <br /> 7. ) i ❑ un,1 s <br /> Unit 6 <br /> 10 <br /> Specific Date Range of InfonT ation Requested:From I CC to D C` S.2r1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES I^5/0'- <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) n HOUSING ABATEMENT 14 SOLID WASTE FACIUTYIVEHICLE <br /> Z OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY M WASTE TIRG 3 <br /> UNDERGAOUND TANK(MONIYORINGIREMOVAL)}( M DOC KENNEL 0 DAIRY /q/D1 <br /> .t HA7ARCOUS WASTE GENERATOR( ~'\ 0CHICKEN RANCH }Z WASTEWATER TkEATMCNT PLANT II <br /> 1K TIEREO PmmirrEo FACILI7YC/\ 0 MOTWHOTEL 0 PUMPER TRUCKIYARDICHEM TOILETS <br /> 0 TAYTOo/BODY PIERCING M POOI.ISPA LAND USE APPLICATION SITES <br /> En MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL ANA SEP'71C PLtc��--ill`����IT RECORDS ARE AVAILABLF FOR REVIEW-MONDAY-FRIDAY 8:00 AM-5:OOPm -EXCLUDING HOLIDAYS. <br /> 1. List up to ten addresses i�the space above. Select the type(s)of files from the IhO above by checking the appropriate <br /> box(ez). At least one file pe MUST be selected. Fag t4(209)46"138 or mail to the address indicated above__ Address <br /> ranges will not be acceptegl-for additlonal aseistance with file addresses,contact the EHD- Applications received after <br /> 3^00 pm will be processed a next business day. <br /> 2. The FHD will notify the apolicant if any EHD files exist An appointment for review will be confirmed approximately ten(10) <br /> days atter receipt of apple tion. The files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled aCCo dingly. <br /> 3. A We that is actively beingworked on by EHD staff may not be immediately available for review. A new application may be <br /> submitted when the Erle is yaliable, <br /> 4. Any file not retumed in the same condition as reieased will be reorganized by EHD staff at the expense of the applicant- <br /> Future file reviews oby the me applicant tray require a$105 deposit prior to review. <br /> EHD USE ONLY <br /> lboG V l r�o - 16v <br /> � © �OOap�l�l <br /> EHO 48-06 5104108 PT BIC RECORDS�E APP F R ZD <br /> CO DOD(Dy I2, .C1�00i)(P&M,; (,DOio(0 90& I Gp000�5�N, Doo� 9 c�pD/I$l sl to©� '� I <br /> WODI `62(D�l (,foo(91Li 1 Woo l4S-121 6600Z03e0l �DD zlU I Cp©DzsKu(o� COWZ733�-' <br /> �pD2b�lsl TOTAL P.02 <br /> � I <br />