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CEIVED <br />SAN A 1� � 17 2�1 Environmental Health Department <br />--- C 0 U N T Y -- - PUBLIC RECORDS RELEASE APPLICATION <br />ENVIRONMENTAL � <br />• <br />I BY EMAL <br />PERMiTSEa�EHD LOG NUMBER- VVV VV ,51 <br />• <br />APPLICANT: Rebecca Natal <br />ADDRESS: 837 Shaw Road <br />BUSINESS/AGENCY: Advanced GeoEnvironmental <br />CITY/STATE/ZIP: Stockton. California, 95215 <br />PHONE (1): 209-467-1006 PHONE (2): 209-623-7200 FAX OR E-MAIL: Rnatal@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 />SIGNATURE OF APPLICANT DATE a l,,zoi,. <br />1. List up to ten addresses in the space below. Address ranges WILL NOT be accepted. Select the type(s) of files from the <br />list below by checking the appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-0138, mail to the <br />address indicated below, or email to info(a)sicehd.com. Applications received after 3:00 pm will be processed the next <br />business day. <br />2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted below. <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 business days for review. Appointments <br />should be scheduled accordingly. <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 $152 deposit prior to review. <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) <br />Electronic Information: ❑ List ❑ Map — Description: <br />Specific Date Range of Information Requested: From to <br />ENVIRONMENTAL <br />FILE ADDRESS <br />_,�-c►D <br />Pnx' *d q1)? <br />HEALTH DEPARTMENT <br />FILES <br />(Specific addresses <br />only, address ranges will not <br />be accepted) <br />EHD <br />USE ONLY <br />❑x Underground Tank (UST) <br />Street # <br />Street Name <br />City <br />1 <br />1931 <br />E Oak St <br />Stockton <br />❑ CONSUMER <br />Cleanup Site (LOP) <br />Q Other Cleanup Site (Non -LOP) <br />❑X Hazardous Waste <br />HM H�✓ (�}� <br />` <br />❑ DAIRY <br />Tiered Permitted Facility <br />Rx Tiered <br />2 <br />1722 <br />E Flora St <br />Stockton <br />❑X Aboveground Tank <br />C,0 <br />❑PWS <br />Fx UST (Monitoring / Removal) <br />3 <br />1903 <br />E Fremont St <br />Stockton <br />Q Hazardous Materials <br />7 Spill / Release ResponseWATER <br />wSl <br />QUALIT <br />IR"F] <br />F1 Solid Waste Facility/Vehicle <br />4 <br />1960 <br />E Fremont St <br />Stockton <br />Food Facility <br />5 <br />1908 <br />E Fremont St <br />Stockton <br />j 1P 1�1{� /I <br />TE MITIGATION <br />[—]Pool / Spa <br />❑ Dairy <br />Q Land Use Application Sites <br />/ <br />7 <br />❑HOUSING <br />❑ Septic Pumper Truck 1 <br />6 <br />2001 <br />E Fremont St <br />Stockton <br />Yard / Chemical Toilets <br />Q Wastewater Treatment Plant <br />❑ Housing Abatement <br />1 <br />2010 <br />E Fremont St <br />Stockton <br />HP�,t tr✓ SSCP6UPA <br />AST/HM/HW <br />❑ Motel/Hotel <br />Chicken Ranch / Dog Kennel <br />8 <br />2040 <br />E Fremont St <br />Stockton <br />CUPA <br />UST <br />F-1medicalWaste Facility <br />❑ Tattoo/Body Piercing <br />❑ SOLID WASTE <br />❑ Waste Tire <br />9 <br />Q Complaint <br />❑ ACCOUNTING <br />Other (Please Specify): <br />10 <br />***BOXED AREA - EHD USE ONLY <br />, A 9 mu 04- AP % V; <br />r <br />A I I v -ii 04 nr, r 7 244-7 %Gi ev . 0 o -r-1 -4 i <br />1 I, <br />❑ Records provided by Staff -PPR Complete. staff Name: EHD 48-0e <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />ri <br />