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K1=(;t1VC1j <br />SHRJOQQW310 2013 Environmental Health Department <br />—COUNTY— PUBLIC RECORDS RELEASE APPLICATION <br />Ef1VIAt �t>R 117H� <br />• ct ff/8EfP.'SE9 <br />SUBMIT BY EMAIL <br />(/•, EHD LOG NUMBER: <br />APPLICANT: Rebecca Natal BUSINESS/AGENCY: Advanced GeoEnvironmental, Inc <br />ADDRESS: 637 Shaw Road CITY/STATE/ZIP: Stockton/CA/95215 <br />L� <br />PHONE (1): 209-467-1006 PHONE (2):209-623-7200 FAX OR E-MAIL: Rnatal@advgeoenacom <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 ','x92616 <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. Y• <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 />SSD delle -4. <br />HEALTH DEPARTMENT <br />FILES <br />(Specific addresses <br />only, atltlress ran es will not <br />y 0 <br />be ecce ted <br />p ) <br />EHD USE O LY <br />RX Underground Tank (UST) <br />street # <br />Street Name <br />City <br />1 <br />Cleanup Site(LOP)CONSUMER <br />Q Other Cleanup Site (Non -LOP) <br />FX Hazardous Waste <br />HM ° Dnia <br />Q Tiered Permitted Facility <br />= <br />1850 <br />East Oak St <br />Stockton <br />Q Aboveground Tank <br />3 <br />1924 <br />East Park St <br />Stockton <br />° Pws <br />O UST (Monitoring / Removal) <br />X❑ Hazardous Materials <br />XQ Spill / Release Response <br />4 <br />WATEHQWLInY <br />Solid Waste Facility/Vehicle <br />Food Facility <br />—I A/ <br />Sne Mmr>+noH <br />❑ Pool / Spa <br />❑ Dairy <br />6 <br />❑ Land Use Application Sites <br />8 <br />° Housiuc <br />Septic Pumper Truck / <br />Yard / Chemical Toilets <br />Wastewater Treatment Plant <br />CUPA <br />Housing Abatement <br />7 <br />AST/HM/HW <br />❑ Motel/Hotel <br />CUPA <br />❑ Chicken Ranch / Dog Kennel <br />Medical Waste Facility <br />a <br />UST <br />Tattoo/Body Piercing <br />° Souo wns,s <br />❑ Waste Tire <br />e <br />Q Complaint <br />° Acwu mNG <br />E] Other (Please Speedy): <br />10 <br />"'"BOXED AREA - EHD USE ONLY— <br />L o-- `nom deNip L -, 4:v F e PM9 <br />I — fhyldocit <br />❑ Records provided by Staff -PPR Complete. Staff Name: END 48-oa <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />