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'0 0912312015 15:49 (FAX) P.0011001 <br /> as <br /> s ra <br /> 1% <br /> a�6 DATE RECEIVED EHD LOO NUMBER <br /> SAN JOAQUIN COUNTY <br /> RECEIVED ENVIRONMENTAL HEALTH DEPARTMENT <br /> t' SEP � '2Q15 1668 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> s` Telephone: (209) 468-3420 Fax: (209)464-0138 Web: WWW.6jg0v.org/ehd <br /> ENARONMENTAL€dt ALI'M PUBLIC RECORDS RELEASE APPLICATION <br /> .MRMITTEHVIL;ht� <br /> APPLICANT: JenniferBerjikian BUSINESS/AGENCY:AdvanoadGaoEnvironmental <br /> ADDRESS; 837 Shaw Road CITY/STATEIZIP;Stockton,CA 95215 <br /> PHONE (1): 209.467-ICOM PHONE (2): 209-483-3401 FACSIMILE: 209-467-1118 <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange n-app intmant date and time to review the requested records. <br /> ❑ CHECK BOX TO EXPEDI $130 FEE OR CHECK ONLY)-REQUEST PROCESSED IN//3��BUSINryEESS S <br /> SIGNATURE OF APPLICA T ,F"- DATE <br /> Electronic Information: ❑ L s Map- er flora: <br /> FILE ADDRESS <br /> street fi street Name City (�' U q !r t1C Ln O <br /> 2. Unit <br /> 3. 140D Vidor Road Lodi <br /> 4, 1220 East Vidor Road Lodi y unct2H <br /> /J <br /> S. 1301 East Lockford Lodi <br /> 6. 1 400 North Cluff Lodi <br /> - 7• p'Unit4 <br /> 8 SITE MITIGATION <br /> 8. <br /> 10. ❑Unit 5 <br /> Specific Date Range of Information Requested: From to <br /> r ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> u UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILrrY/VEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> ®UNDERGROUND TANK(MONrTORING/REMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ❑ABOVEGROUND TANK ❑CHICKEN RANCH!DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> ❑HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOU$PA ❑LAND USE APPLICATION SITES <br /> ❑TATTOO/BODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELLAND 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 flies 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 tindicated lol <br /> bove Address <br /> ranges will not be accepted.Applications received after 3:00 pm will ha 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 reeelpt of application. The flies will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 4. Any file net returned In the same condition as released willf 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. "'fdOXED AREA-EHD USEONLY— <br /> U-ca" kr- Drty {.mr l too vytorQ l-sol 4yoL.ir Ate. P3a;JeJ P1000 L1 v CO <br /> (,,,U 1400 Vnc+s7 Rd 1 o I J•tr LAt70 C[UK M. <br /> e,! 510V /ar I tr( d 491 GO l 7� G o 29`1 uA 72g• <br /> I <br /> ❑ Records provided by Staff-PPR Complete. staff Name: <br /> EHD 48-06 <br /> Received Time Sep. 23. 2015(3 ;42PM-No. 9632 <br />