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1012712016 09:54 (FAX) P.0011001 <br />■ <br />RECEIVEDa � EHD LOG NUMBER <br />■ SAN JOAQUIN COUNTY <br />■� ENVIRONMENTAL HEALTH DEPARTMENT <br />OCT 20i 1868 East Hazelton Avenue, Stockton, CA 95205-6232 411C <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br />—REQAAr'rak7RI- h� PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: g9beCCa Natal BUSINESS/AGENCY: Advanced GeoEnvironmental Inc. <br />ADDRESS: 837 Shaw Road CITY/STATE/ZIP: Stockton, CA 9521 � <br />PHONE (1): 209-467-1006 PHONE (2): 209-323-7200 FAX OR E-MAIL: lnatal(ct�advgeoenv.com <br />Please allow 10 business days from date of application submittal for the records to be available. <br />Staff will contact you to arrange an appointment date and time to review the requested records. <br />CHECK BOX TO EXP�DI E 5EQUEST - $138 F ASH OR CH ONLY) - REQUEST PROCESSED IN 3 BUSINESS AYS <br />SIGNATURE OF APPLICANT DATE O 2� <br />1. 1-16t up to ten addresses in the space below. Seldet ihe type(s) of files from the list below by checking the appropriate <br />box(es). At least one file type MUST be selected. Fax to (209) 464-0138 or mail to the address lodlceted above. Address <br />ranges will not be accepted. Applications received after 3:00 pm will be processed the next business day. <br />2. For assistance In Identifying the nature and content of EHD records, please contact EHD at the number noted above. <br />3. 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 businesa days for review. Appointments <br />should be scheduled accordingly. <br />4. Any rile 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 $139 deposit prior to review. <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8.00 AM•5:00PM (EXCLUDING HOLIDAYS) <br />Electronic Information: ❑ List ❑ Map — Description: <br />Speclfic Date Range of Information Requested: From to <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />FILES <br />FILE ADDRESS <br />EHD USE ONLY <br />UNDERGROUND TANK (UST) <br />Street 4 <br />Street Name <br />city <br />303 <br />S Cherokee Ln <br />Lodi <br />E] CONSUMER <br />�'�.�:j `-• <br />�{ CLEANUP SITE (LOP) <br />OTHPR CLEANUP SITE(NON•LOP) <br />Y-' <br />HAZARDOUS WA&TE <br />TIERED PERLIfRTED FACILITY <br />ABOVEGROUND TANK <br />420 . <br />S Cherokee Ln <br />Lodi <br />p,NRv <br />UST (MONITORING/REMOVAL) <br />HAZARDOUS MATERIALS <br />SPILL/REL@ASE RESPONSE <br />SOLID WASTE FACILITY / VEHICLE/401Gj <br />FOOD FACILITY <br />° <br />812 <br />S Cherokee Ln <br />Lodi1�� <br />PWS <br />SCherokee Ln <br />Lodi <br />WATER QUALITT <br />� �- <br />POOL/SPA <br />F7Srty <br />❑ DAIRY <br />MmannoN <br />LAND UBE APPLICATION SITES <br />0 NO1161NG <br />SEPTIC PLIARPER TRUCK / <br />YARD / CHEUIDAI TOILETS <br />❑ WASTEWATER TREATMENT PLANT <br />P HOUSING ABATEMENT <br />a <br />til CLA L <br />7 <br />Q' CUPA <br />❑ MOTEL/HOTEL <br />❑ CHICKEN RANCH / Doo KENNEL <br />C (IPA - UST <br />MEDICAL WAUTE FACILITY <br />B <br />❑ TATWBODY PIERCING <br />9 <br />[] S"ID WASTII <br />- <br />❑ WASTE TIRE <br />XCOMPIAINT <br />0 OTHER(PLEASE SPFCIFY); <br />10 <br />ACCOUNTING <br />XED AREA - <br />M Records provided by Staff -PPR Complete. Staff Name: ) �!k(✓ <br />Received Time Oct, 21, 2016— 9:34Af1INO. 023J <br />I <br />V1 <br />