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a` 09!23/2015 15:49 (179) P.001/001 <br /> 3GkT DATE RECEIVED EHD LOO NUM3ER <br /> ea SAN JOAQUIN COUNTY <br /> R EVED ENVIRONMENTAL HEALTH DEPARTMENT <br /> SEP -�Qt5 1868 East Hazelton Avenue, Stockton, CA 95205-6232 6 <br /> Telephone: (209)458-3420 Fax: (209)464-0136 Web: vvww.sjgov.org/ehd <br /> ENVIHCNMENTALHEALfN PUBLIC RECORDS RELEASE APPLICATION <br /> FERMIT7SERVIUE5 <br /> APPLICANT: JenniferBerjikian BUSINESS/AGENCY:AdvancedGGoEnvironmental <br /> ADDRESS: 837 Shaw Road CITY/8TATEIZIP:Stockton,CA 95215 <br /> PHONE (1): 2„gg-467.1008 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 avallabie. <br /> Staff will contact you to arrange n-app 'ntmant date and time to review the requested records. <br /> ❑ CHECK BOX TO EXPEDI $130 FEE OR CHECK ONLY)-REQUEST PROCESSED IN/3�BUSINESS S <br /> SIGNATURE OF APPLIC T 0 DATE 0I <br /> Electronic Information: E] s L Map- e tion: <br /> FILE ADDRESS <br /> Street# Streat Name city EHq UEgO�l�t <br /> 1. <br /> 2• `a_1� Q Unit 1 <br /> 1400 Vidor Road Lodi <br /> ;F✓� 4, 1220 East Victor Road Lodi 5 Unit 2H <br /> �J <br /> S. 1301 EastLockford Lodi 5rtf ^ cam" std 01 /AQy <br /> 6. 400 North Cluff Lodi Lr NV-rA, Hwr{t-i0 Up // G° <br /> 7. 0 Unit4 <br /> 8• SITE MITIGATION <br /> 9. <br /> 10. ❑Unit 5 <br /> Specific Date Range of Infomatlon Requestad: From to <br /> r ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> u UNDERGROUND TANK(UST)CLEANUP SIrE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILnYIYEHICLE <br /> ®OTHER CLEANUP SITE(NON•LOP) ❑HOUSING+ABATEMENT ❑WASTE TIRE <br /> ®UNDERGROUND TANK(MONRORINOIREMOvAL) ❑FOOD FACILITY ❑DAIRY <br /> ❑ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> ❑HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTEUHOTEL ❑PUMPER TRUCKiYARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SrrES <br /> ❑TATToo/BODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM•5:0OPM(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)484.0138 or mall 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 Flies 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$130 deposit prior to review. ""BOXED AREA-EHD USE ONLY" <br /> ( L,Cw r'r �0r 1tooUL+or kj,l ot i.SLk10 AS-F .L 4j0C.lu A.ve.. PjJ,Sd Ole4V Go <br /> �f 1400 \/((.+w\/((.+wRa (. o LddXjWk CUsOC1v4( n7�, I F>,1 i v Lh tar i400 UuK PAC <br /> t4 <br /> I ea 51D .a4lar I m 491 (,!l l 2�. L o 269 un -72$• <br /> ❑ Records provided by Staff-PPR Complete. staff Name: <br /> ETD-4"t <br /> 'lHI56 <br /> Received Time Sep. 23. 201rr3`:42PM` Io. 9632 <br />