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DATE RECEIVED )% • f - EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> 'y�(, ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> i ( r Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:Robert Anderson BUSINESS/AGENCY: GaiaTech <br /> ADDRESS: 2223 S. Sherman Street CITY/STATE/Zip:—Denver, CO 80210 <br /> 620-4197 PHONE (2): email: randerson@gaiatech.com <br /> PHONE (1): 773- <br /> TENTATIVE`APPOINTMENT DATE: 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 Robert Anderson DATE 3/10/14 <br /> Electronic Information: X List❑ Map—Description: <br /> FILE ADDRESS _ EHD USE ONLY <br /> «�P <br /> Street# Street Name city y7 y '° n MM if 0 ❑Unit 1 <br /> —1 -8-00—B --Stockton Church Street Stockton <br /> 2. 2575 Grand Canal Boulevard NFG Stockton ❑Unit <br /> 3. <br /> 4. Ej Unit 3 <br /> 5. <br /> 6. _ ❑ Unit 4 <br /> 7. <br /> r9. <br /> El Unit 5 <br /> ❑Unit 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> X UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY X SOLID WASTE FACILITYIVEHICLE JOIC' <br /> X OTHER CLEANUP SITE(NON-LOP) ❑HOUSING A13ATEMENT ❑WASTE TIRE '�Id <br /> IX UNDERGROUND TANK(MONITORINGIREMOVAL) El FOOD FACILITY DAIRY )J,� , <br /> X ABOVEGROUNDTANK ❑CHICKEN RANCHI DOG KENNEL X WASTEWATER TREATMENT PLANT 5'14 <br /> X HAZARDOUSWASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL LJ PUMPER TRUCKNARDICHEMICAL TOILETS <br /> X TIERED PERMITTED FACILITY n POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING X COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(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 ap0licant. <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. "BOXED AREA-EHD USE ONLY <br /> 3-19-t _ <br /> r A d b <br /> t o <br /> 1 <br /> ❑ Records provided by Staff-PPR Complete. staff Name: C <br /> 914112 <br />