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IIS® 10/28/2015 09:02 (FAX) P.0011001 ma Im RFKE:OWSTAN JOAQUEN COUNTY EHDLO.GNUMBER OCT 28 2015 ENVIRONMENTAL HEALTH DEPARTMENT SS 1868 East Hazelton Avenue, Stockton, CA 95205-6232 ENVIRONMENTAL HEALfl�laphone, (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION APPLICANT: Jennifer Derjlklan BUS INESSfAGENCY:Advanced GeoEnvironmental ADDRESS: 837 Shaw Road CITY/STATEIZIP: Stockton,CA 95215 PHONE (1). 209-467-1008 PHONE(2): 209-4833461 - FACSIMILE:209-467-1118 Please allow 10 business days from date of application submittal for the records to be available. Staff will contact you to arrange an appointment date and time to review the requested records: ❑CHECK BCX TO EXPEDITEREQUE CASH OR CHECK ONLY).REQUEST PROCESSED IN t�TINESS DAYS SIGNATURE OF APPLICANT DATE Electronic Information; ❑ Llst Map—Description: FILE ADDRESS \I/ EHD USE ONLY JUL, Street 0 Street Name city 1. 825 Navy Drive StocktonOJ"t° �. 2. 1137 South Stockton Street Stockton Ctit -( �DT} W iti Odlt 1 3. 1240 Navy Drive Stockton n t 2 J 4. 1145 West Charter Way Stockton LLcv,-t y14-64',I 1 / S. 939 West Charter Way Stockton r P)t -41a l IiVJ 6. (A5-t -L0 P v IZP! Ut /nJ lt 7. Vi' R1 nIt4 8• I1' -1 . ,61TTE MITIGATION 9 10. nit 6 Speclflc Date Range of Informatlon Requested: From to ENVIRONMENTAL HEALTH DEPARTMENT FILES n1�-- UNDERGROUND TANK(UST)CLEANUP SITE(LOP) [:]MEDICAL WASTE FACILITY ❑V S.OLID WASTE FACILISYNEHICLE LATHER CLEANUP SITE(NON•LOP) [3HOUSIHe ABATEMENT ❑'tlPA,STE TIRE ❑yNDFROROUND TANK(MONITORING/REMOVAL) ❑FOOD FACILITY ❑DAIRY BOVEGROUND TANK [jCHICKEN RANCH( []KENNEL ❑WASTEWATER TREATMENT PLANT ©.,1a LRAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MoTEL/HOTEL [],PUMPER TRUCK/YARDICHEMICAL TOILETS ❑TIERED PERMITTED FACILITY PZO-L/SPA ❑LAND USE APPLICATION SITES F1TATTOo(a00Y PIERCING COMPLANT/RESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY•FRWAY 8:00 AM•5:00PM(EXCLUDING HOLIDAYS) 1. List u0 to ten addresses In the space above. Select the type(s)of files from the list above by checking the appropriate box(es). At least one fila type MUST be selected. Fax to(2091464-0138 or mall to the address Indicated above. Address ranges Will not be accepted.Applications received after 3:00 pm will be processed the next business day. 2. For assistance In Identifying the nature and content of EHD records, please contact EHD at the number noted above, 3. The EHD will notify the applicant If any EHD Was exist. An appointment for reviewwlll be confirmed approximately ten(10) days atter receipt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the expense of the applicant. Future file reviews by the same applicant may require a$130 deposit prior to review. "*BOXED AREA-EHD USE ONLY' Rua 5Z, lb990'5+ 1140 Npi.,& 1131 5{atMl I I(4 L/A J, A UST A A ILK U.w c.GD. cA�aA 1 w fi fel 41 +-1140 kAw Il 4 t CI, JIEr lM Cly. Cmw I k 1>S lr,1h k Z i(e 4r 11 ( fon J6l. t C0 7 z .N It' fila r P zyt7 Nov Comnits Cof (40, ❑ Records provided by Staff-FPR Complete.staff Name: LOa, btA(a OA CL?LO)5 YtA 'v r �� Eno ae-ue Llwv ,1/ 'J' )tij1 5117t• t:y for Cow plut.Aty C,' Received Time Oct. 28, 2015 8: 54AM No. 9891 (,OLL,,p'7375tciaw"I3)5,k (orLt(A5 t�w,nC/. , to-AµOk(t76*382 it.i4kif Ab L, 911; A.1A,;,,, AP. P&7vikk CO«A U,,GOt,utigl-S&. L COuIOI*C;& JLAkr I' NAA IVMA„*.