Laserfiche WebLink
Advanced GeoEnviroiFax: (707) 570.1461 To: 2094640138^@rcfax-con Fax: +12094640138 Page 1 of 1 03131/2016 4:05 PM <br />EHD LOG NUMBER <br />�gDA 1V SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />=� APR 0 t 2016 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: \wvw.sjgov.org/ehd <br />'_ENV1RONMENTAL HEALTH <br />PEERMIT/SEWCES PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: Jennifer Berjikian BUSINESS/AGENCY:Advanced Geo Environmental <br />ADDRESS: 3335 East Miraloma Avenue <br />CITY/STATE/ZIP: Anaheim, CA 62806 <br />PHONE (1): 800-511-9300 PHONE (2):209-483-3401 FAX OR E-MAIL:jberjikian _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 anld time to review the requested records. <br />❑ CHECK BOX TO EXPEDITE REQUEST - $130 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT 'rl;":: '- DATE 03/31/2016 <br />Electronic Information: ❑ List ❑ Map — Description: <br />FILE ADDRESS <br />EHD USE ONLY <br />Street 9 <br />Street Name <br />City <br />1 • <br />686 <br />East Lockford <br />Lodi <br />�1 i� <br />[I Unit 1 <br />j' 1�1'h'./Icxm` <br />2• <br />9001/2 <br />East Victor Road <br />Lodi <br />3. <br />930 <br />East Victor Road <br />Lodi <br />2I'a _ .�� I / Unit 2 <br />l <br />4. <br />5. <br />1220 <br />687 <br />East Victor Road <br />East Lockford Street <br />Lodi <br />Lodi <br />E Unit 2H <br />[9/Unit 3 <br />681 <br />East Lockford Street <br />Lodi <br />/ <br />. <br />925 <br />South Victor Street <br />Lodi <br />❑ Unit 4 <br />,1� <br />[9 SITE MITIGATION <br />❑ Unit 5 <br />10. <br />,1 <br />�✓t <br />Specific Date Range of Information Requested: From to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />RI UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ MOTELIHOTEL ❑ SOLID WASTE FACILITY [VEHICLE <br />® OTHER CLEANUP SITE (NON -LOP) ❑ HOUSING ABATEMENT ❑ FOOD FACILITY <br />X❑ UNDERGROUND TANK (M ONITORINGIREM OVAL) ❑ WASTE TIRE ❑ DAIRY, POOLISPA <br />X❑ ABOVEGROUND TANK ❑ CHICKEN `RANCH/ DOG KENNEL ❑ WASTEWATER TREATMENT PLANT <br />,J HAZr^RDOUS . 51 E Lj MEDICAL AJA.T1E FACILITY ❑ f UIVIPER TRUCK-' RD'CHEMICAL I TOILETS <br />X❑ HAZARDOUS MATERIALS ❑ TATTOOGODY PIERCING ❑ LAND USE APPLICATIONS ITES <br />TIERED PERMITTED FACILITY ❑ COMPLAINTIRESPONSE RECORDS ❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:00PM (EXCLUDING HOLIDAYS) <br />1. List up to ten addresses in the space above. Select the type(s) of files from the list above 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 indicated 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 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 $130 deposit prior to review. <br />'BOXED AREA - EHD USE ONLY' <br />F Records nrovided by Staff-BPR-Co7nnlete. Staff Name: <br />Received Tiriie=Mar, 31.=2016` 4�No, 0645 <br />