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■ 01/04/2016 10:12 (FAX) P.0011001 <br /> ■ 7�WEI9VE e <br /> ® <br /> TEHD LOG NUMBER <br /> \6.vv i SAN JOA4UIN COUNTY <br /> JAN 0 k 2096 ENVIRONMENTAL HEALTH DEPARTMENT �� <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 9 06 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sj90v,Org/ehd <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Jennifer Beriikian <br /> BUSINESS/AGENCYAdvanced Goo Environmental <br /> ADDRESS: 837 Shaw Road- CITY/STATE/ZIP$tockton,CA 95215 <br /> PHONE (1): 209-467-1006 PHONE(2): 209-483-3401 FAX OR E-MAIL:209467.1118 <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> CHECK BOX TO EXPEDITE RE $130 FEE AS CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 1/04/2016 <br /> Electronic Information: ❑ List❑Map-Description: <br /> FILE ADDRESS <br /> Straat Street NameEHD USE ONLY <br /> city <br /> 1. 201 West Edison Street Manteca ho col <br /> 2. 721 North Main Street enlace ❑Unit 1 <br /> 3. <br /> • 0 l0/�j <br /> 4 ❑Unit 2 <br /> 6 ❑Unit 2H <br /> a [3�It3 ��, .i <br /> 7 nit 3HM <br /> a. aUnit 49. . <br /> ©"SITE MITIGATION <br /> 10. 17U'nit ti <br /> Spminc Dete Psnge of infomution Regwste: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES® �Q UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MOTEL/HOTEL ®SOLID WASTE FACILIT�YIG�EOHI"CLE <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑FOOD FACILITY <br /> ®UNDERGROUND TANK(MOMT)RINGIREMOVAL)oC ®WASTE TIRE <br /> ®ABOVEGROUND TANK'G ❑CHICKEN RANCR/DOG KENNEL ❑DASTEWA ERTRUSPA Ib� )ANT-( (� <br /> ®HAZARDOUS WAST4>e ❑WASTEWATER TREATMENT PLANT <br /> ©HAZARDOUS MATERIALS ❑MEDICAL WASTE FACILITY ❑PUMIDLAND RTRUCR APPLICATION <br /> SI NfItlALT01LErS <br /> ❑TIERED PERMITTED FACILITY ❑TATTOO/BODY PlEkCINSPONSEG ❑LAND (PLEASE <br /> SITES <br /> ®COMPLAINT/RESPONSE RECORDS (I OTHER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY•FRI0AY8ADA*S;OOPM(EXCLLmI.NGHOLIneySI, <br /> 1. List uo to ten addresses in the space above. Select the type(s)of flies 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 mall to the address India above Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the.next business day. <br /> 2. For assistance in identifying the nature and content of EHD records,please contact EHD at the number noted above. <br /> 3. Tiro EHD will notify the applicant if any EHD tiles exist. An appointment for review will be confirmed approximately ten(10) <br /> days atter receipt of application. The files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. - <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$130 deposit prior to review. <br /> AREA-E ONLY'" <br /> ❑ Records provided by Staff-PPR Complete. Stan Name: <br /> Received Time Jan. 4. 2016 10; 03AM No- 0266 <br />