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A°:Advanced GeoEnviroiFax:(707)570.1461 To:209464013.1@ rcfax.con Fax: +12094640133 Page 1 of 1 10/1612014 12:33 <br /> EHD LOG NUMBER <br /> SAN .10AQUIN COUNTY <br /> i° ENVIRONMENTAL HEALTH DEPARTMENT <br /> OCT 16 2014 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web. tvww.sjgov.org/ehd t �; <br /> ENVIRONMENTAL HEALTH <br /> PERMITISERVICES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Rebecca Natal BUSINESS/AGENCY: Advanced Geo Environmental <br /> ADDRESS: 837 Shaw Road CITYISTATE/ZIP: Stockton/CA/95215 <br /> PHONE(1): 209-467-1006 PHONE(2): 209-623-7200 FACSIMILE: 209-467-1118 <br /> TENTATIVE*APPOINTMENT DATE: ASAP Time: <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑Unit 1 <br /> 1. 1155 West Center Street Manteca t C0 <br /> 2. 1110 Eucalyptus Street Manteca 0$�'N ,I Unit 2 , <br /> 3. 3233 Lance Drive Stockton I0(17 / / I L. <br /> 4. 1631 East Louise Avenue LathropI' <br /> /❑Unit 3 <br /> 5. 2449 West Kettleman Lane Lodi / <br /> 6. � { Unit 4 <br /> 7. <br /> 8. ❑Unit 5 <br /> 9. <br /> 10.`'° ❑Unit 6 <br /> Specific Date Range of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> x❑UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITYNEHICLE <br /> x❑OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> x❑UNDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL ❑DAIRY <br /> ❑HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOLISPAx❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITYx❑COMPLAINT 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-for additional assistance with file addresses,contact the EHD. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. 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 /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may be <br /> submitted when the file is available. <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$125 deposit prior to review. <br /> EHO USE ONLY <br /> Received Time Oct. 16. 2014 12: 29PM No. 7343 $""' <br />