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RECEIVED <br /> S A N J Q A Q U I N MAY r 3 2018 Environmental Health Department <br /> -- CGU N T Y- - PUBLIC RECORDS RELEASE APPLICATION <br /> EW <br /> MAIL SIC <br /> EHD LOG NUMBER. <br /> APPLICANT: Rebecca Natal BUSINESS/AGENCY:Advanced GeoEnvironmental,Inc. <br /> ADDRESS: 837 Shaw Road CITY/STATEIZIP:Stockton,CA 95215 <br /> PHONE(1): 209-467-1006 PHONE(2):209-623-7200 FAX OR E-MAIL: Rnatal@advgeoenv.com <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 /> SIGNATURE OF APPLICANT DATE 51-213,12016 <br /> 1. List up to ten addresses in the space below. Address ranges WILL NOT be accepted. Select the type(s)of files from the <br /> list below by checking the appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138, mail to the <br /> address indicated below, or email to info(a)sicehd.com. Applications received after 3:00 pm will be processed the next <br /> business day. <br /> 2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted below. <br /> 3. 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 /> 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$152 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES (Specific addresses only,address ranges will not be accepted) EHD USE ONLY <br /> Q Underground Tank(UST) Street# Street Name city <br /> CONSUMER <br /> Cleanup Site(LOP) aW ❑ <br /> QOther Cleanup Site(Non-LOP) 1 121 E Lindsay St Stockton �� - <br /> • Q Hazardous Waste L ❑DAIRY <br /> QTiered Permitted Facility 2 118 E Fremont St Stockton i <br /> 0 Aboveground Tank <br /> ❑PWS <br /> ❑K UST (Monitoring/Removal) 417 N Hunter <br /> me r <br /> a ckton <br /> ❑x Hazardous Materials <br /> � i <br /> xj Spill I Release Response Area QUALITY <br /> Solid Waste Facility/Vehicle 4 419 N Hunter kto n <br /> Food Facility (� <br /> Pool/Spa © ITE MITIGATION <br /> Dairy 1, 423Dairy N Hunter OIL kton i <br /> t <br /> Q Land Use Application Sites i <br /> ❑HOUSING <br /> ❑Septic Pumper Truck 1 6 120 E Fremont c kto n <br /> Yard/Chemical Toilets <br /> Wastewater Treatment Plant CUPA <br /> I]Housing Abatement 7 124 E F re m o n tat, fckton AST I HM I HW <br /> Motel/Hotel <br /> SKUPA <br /> Chicken Ranch/Dog Kennel400 N El Dorado St Stockton UST <br /> a <br /> ❑Medical Waste Facility �C <br /> F]Tattoo/Body Piercing ❑SOLID WASTE <br /> Waste Tire 9 404 N EI Dorado N ckton <br /> Q Complaint <br /> Other(Please Specify): El ACCOUNTING <br /> 1° 416 N EI Dorad ckton <br /> —BOXED AREA-EHD USE ONLY+— j <br /> - <br /> a ? f <br /> ❑ Records provided by Staff-PPR Complete. staff Name: EHD4s-06 <br /> r <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />