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i■ <br />0 :Advanced GeoEnviroiFax: (707) 570-1461 To: 2094640138@rcfax.con Fax: +12094640138 Page 1 of 1 1011612014EHDLOGNUMBER <br />:%'M ": NEE SAN .1OAQUIN COUNTY ,p <br />�■� 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: twww.sjgov.org/ehd <br />ENVIRONMENTAL HEALTH <br />PERMITISERVICES <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: Rebecca Natal BUSINESS/AGENCY: Advanced Geo Environmental <br />ADDRESS: 837 Shaw Road CITY/STATEOP: Stockton / CA / 95215 <br />PHONE 0): 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 <br />DATE <br />Electronic Information: ❑ List ❑ Map — Description: <br />all <br />FILE ADDRESS <br />EHD USE ONLY <br />❑ Unit 1 <br />HEALTH DEPARTMENT FILES <br />Street # <br />Street Name <br />City <br />1. <br />1155 <br />West Center Street <br />Manteca <br />ZI Unit 2 <br />2. <br />1110 <br />Eucalyptus Street <br />Manteca <br />3. <br />3233 <br />Lance Drive <br />Stockton <br />/I] Unit 3 <br />4. <br />1631 <br />East Louise Avenue <br />Lathrop <br />5. <br />2449 <br />West Kettleman Lane <br />Lodi <br />� l Znit 4 <br />6. <br />7. <br />❑ Unit 5 <br />8. <br />9. <br />0 Unit 6 <br />10.V <br />Specific Date Range of Information Requested: From <br />all <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT FILES <br />X1 UNDERGROUND TANK (UST) CLEANUP SITE (LOP) <br />❑ HOUSING ABATEMENT <br />X❑ OTHER CLEANUP SITE (NON -LOP) <br />❑ FOOD FACILITY <br />Q UNDERGROUND TANK (MONITORINGIREMOVAL) <br />❑ DOG KENNEL <br />❑ HAZARDOUS WASTE GENERATOR <br />❑ CHICKEN RANCH <br />❑ TIERED PERMITTED FACILITY <br />❑ MOTELIHOTEL <br />❑ TATTOOIBODY PIERCING <br />❑ POOL/SPA <br />❑ MEDICAL WASTE FACILITY <br />Q COMPLAINT RECORDS <br />to <br />❑ SOLID WASTE FACILITYNEHICLE <br />❑ WASTE TIRE <br />❑ DAIRY <br />❑ WASTEWATER TREATMENT PLANT <br />❑ PUMPER TRUCKIYARDICHEMICAL TOILETS <br />LAND USE APPLICATION SITES <br />❑ 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 />EL D UI E ONLY <br />Received Time Oct. 16. 2014 12:29PM No.7343 $""' <br />