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Aug. 1$. 2005 6:43PM Ad1;,aced GeoEnvironmenkal No. 1762 K 1 <br />DATE RECENED <br />EHD LOG NUMBER <br />ILR�' j [� /� FDJ SAN JOAQUIN COUNTY' <br />LS C E til � ENv- moNmN'TAL HEALTH DEPARTMENT <br />304 Fort Weber Avenue, P Floor, Stockton, CA 95202-2708 <br />,6 f lf-,, I ) 2005 Telephone: (209) 468-3420 Fax; (209) 464-0138 Web: www.sjgov.org/ehd <br />ENVIRONMENT #1EAEThi . PUBLIC RECORDS RELEASE APPLICATION <br />rr�ilvil 1Z) <br />APPLIcArNT: j uisAe Henderson RUSINESSIAGENCY: Advanced GO.' a vironmental; Inc. <br />ADDRESS: 837 Shaw Road Stockton CA 95215 <br />PHONE (1): 209467-1006 PHONE (s): Cell: 208-712-2278 ' r. FACSIMILE: 2Oii1-467-1118 <br />TENTATIVE*APPOiNTMENTDATE: 0 PU��7 _Tirna: �Q ��'Q ate' <br />(Please allow 10 burin from date of appl ion Submittal - *rentRUM oruy - Muat De confirmed) Q <br />fir-,. <br />M CHECK BOX TO EXPEDITE 0 ;93.00 FEE(C H R CHE K ONLY) - REQUEST PROCESSED IN 3 BUSINE83 DAYS <br />SIGNATURE OF APPLICANT DATE �S <br />0111 <br />* <br />■ / r a ■Lei UTMdr=_1rqr-Tr1TP <br />------FILE <br />ADDRESS <br />EHD USE ONLY <br />Specific Date Range of Information Requested: F to- - - <br />ENVIRONME AL HEALTH DEPARTMENT FII_E3 w ¢* <br />* UNDERGROUND TANK (UST) CLEANUP SITE (LOP) 0 HousINO ABATEMENT Q SOLID WASTE FAquTYNBHILLE' <br />W OTHER CLEANUP SITE (NON -LOP) O FOOD FACILITY ❑ WASTE TIRE <br />Ri UNDERGROUND TANK(MONITORINWREMOVAL) U Doli KENNEL Q DAIRY <br />IQ HAZARDOUS WASTE GENERATOR 11 CHICKEN RANCH 13 WASTEWATER TREATMENT PLANT <br />❑ TIERED PER6NITTEO FACILITY ❑ MOTELAiOTEL ❑ PUMPER TRwGWYARWOHEM ToLLETB <br />0 TATTOOIBODY PIERCING ❑ POOUSPA )Q LAND use APPLICATION SITES <br />❑ MEDICAL WASTE FACILITY OTHER (PLEASE SPECIFY) " <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILAHLt= Fon REVIEW - GAONDAY-FRIDAY 8:00 AM-S.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 <br />appropriate box(es). At least one file type MUST be selected. Fax to (2091454-01H or mail to tfie address <br />Indicated above. Address ranges will not be accepted —for additional assistance with file addresses, 60.0act <br />the EHD. Applications received after 3:00 pm will be processed the next business day. <br />2. The EHD will notify the applicant If any EFID files exist. An appointment for review will be confirmed <br />approximately ten (10) days after receipt of application. The files will be held for a maximum of five business <br />days for review. Appointments 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 <br />application may be submitted when the file is available. <br />4. Any file not returned in the same condition as released will be reorganized by EHD staffat the expense of the <br />applicant. Future file reviews by the same applicant may require a $83.00 deposit prior to review. <br />No "42.4m <br />1V140 <br />