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SANAAffiCEWE'Environmental Health Department <br />—C OU NTY�iAY J 0 2018 PUBLIC RECORDS RELEASE APPLICATION <br />• EMVIRONMT�EµN[�TrA''yL {{1Y EMAIL A (S9 V ♦ 6 <br />PERa�I"r i'GR b f'X� EHD LOG NUMBER:y <br />APPLICANT: Rebecca Natal BUSINESS/AGENCY: Advanced GeoEnvironmental, Inc <br />ADDRESS: 837 Shaw Road CITY/STATEIZIP: Stockton/CA/95215 <br />• <br />PHONE (1): 209-467-1006 PHONE (2): 209-623-7200 FAX OR E-MAIL: Rnalal rad:geoenv.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 ms=s§T DATE 0'29/2018 <br />1. List un 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) If <br />Electronic Information: LJ List LJ Map — Description: I <br />Specific Date Range of Information Requested: From to <br />ENVIRONMENTAL <br />FILE ADDRESS <br />J•Cc� � 11 Ile f4' <br />HEALTH DEPARTMENT <br />FILES <br />ponly, <br />( S ecific addresses <br />address ranges will not <br />g <br />be accepted) <br />p ) <br />EHD USE O Y <br />0 a Underground Tank (UST) <br />Street # <br />Street Name <br />city <br />Cleanup Site (LOP) <br />_ <br />❑ CONSUMER <br />1 <br />2991 <br />N Navone Rd <br />Stockton <br />MX Other Cleanup Site (Non -LOP <br />MX Hazardous Waste <br />❑ DAIRY <br />❑x Tiered Permitted Facility <br />2 <br />kh <br />Zx Aboveground Tank <br />n/1-�CJ'�`%C�— 4r, —Q <br />NJ �V_ <br />❑ PWS <br />Q UST (Monitoring / Removal) <br />Q Hazardous Materials <br />0 <br />I`tW <br />Q Spill / Release Response <br />WATER QUALITY <br />Solid Waste Facility I Vehicle <br />4 <br />Food Facility <br />ire MTIGCTION <br />Pool / Spa <br />Dairy <br />6 <br />�X Land Use Application Sites <br />HOUSING <br />Septic Pumper Truck / <br />a <br />Yard / Chemical Toilets <br />Wastewater Treatment Plant <br />VrCUPA <br />Housing Abatement <br />7 <br />AST I HM I HW <br />Motel/Hotel <br />URA <br />Chicken Ranch I Dog Kennel <br />❑ Medical Waste Facility <br />S <br />UST <br />❑ Tattoo/Body Piercing <br />❑ Souo WASTE <br />❑ Waste Tire <br />e <br />Q Complaint <br />❑ Ac srnuc <br />Other (Please Speedy): <br />10 <br />*'BOXED AREA - EHD USE ONLY— <br />r7• 2S- III - - r -.`d -, i v1 J i., o,l. . c'yk Ne ter, t cA—T.,.. 6- <br />1 <br />❑ Records provided by Staff -PPR Complete. staff Name: EHD 8.006 <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />