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01/20/2015 11:03 ffAX) P.0011001 <br /> mim <br /> ■� DATE RECE EHD LOG NUMBER <br /> ■ 0, SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT �rw <br /> °'2' 1868 East Hazelton Avenue, Stockton, CA 95205-6232 © r/ <br /> ,P� d one: (209) 468-3420 Fax: (209)464-0138 Web: www-sjgov.org/ehd <br /> moo' <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Rebecca Natal BUSINESS/AGENCY: Advanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP: Stockton/CA/95215 <br /> PHONE (1): 209-467-1006 PHONE(2):209-623-7200 FACSIMILE: 209-467-1118 <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Phase allow 10 business,days from date of application submlftal-"Tenfadve only-must bo confirmed) <br /> ❑ CHECK BOX TO EXPEDITE R E T-$125 FEE( C CK LY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 1/20/2015 <br /> Electronic information! [] Lint❑ Map— Description: <br /> FILE ADDRESS EHD USEONLY <br /> 1. Street# Street Name City Unit 1 <br /> 1• 3808 West Lane Stockton N - <br /> 2. 4040 West Lane StocktonY M r^a� {w { ST at2 <br /> 3. _ 40,. Enter rise Street Stockton Lo-t 1•h5 v'yo /) P <br /> 4. N U tn`y E vL, GQ ] <br /> Unit3 <br /> S. f � <br /> 6. {A7J��t4� 17-ctley 4, IJ Unit 4 <br /> 7. <br /> e. - <br /> Unxs <br /> 9. <br /> 10. <br /> Unit 8 <br /> Specific Data Ranpe of Informaflon Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUPSITE(LOP) ❑HOUSING ABATEMENT Q SOUD WASTE FACILITYIVEHICLE <br /> x❑OTHER CLEANUP SUE(NON-LOP) ❑FOOD FACILITY QWASTETIRE <br /> 0 UNDERGROUND TANK(MONRORINGIRUIOVAL) ❑DOG KENNEL DAIRY <br /> 0 HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATERTRFATMENT PLANT <br /> Q TIERED PERMITTED FACILITY ❑MOTEUHOTEL ❑PUMPER TRUCIWARDICHEMCAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOUSPAx❑LAND USEAPPLICATK)N SITES <br /> ❑ MEDICAL WASTE FACILITY (]COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEWS MONDAY-FRIDAY B:00 AM-S:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List uD to ten addresses in the space above. Select the typs(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(2091464-0136 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 exlet An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The files will behold for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A Nle 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 applicant <br /> Future file reviews by the same appilcam may require a$125 deposit prior to revlow. <br /> FHO USE ONLY <br /> roJLJed Cb K§ Eiit lot IIAG En flse ('4 LkLA * A -Fly $or 40t v t-Rs*L,a, <br /> �� t)t01'r I •n I`♦te! �' t (yrr Lfi3 Vry} Lam,., <br /> s-t <br /> CO G iii :n L (Lii file W 2, f-PT LAO L4.0 t„cL.LAQ. <br /> Eae� -0a <br /> 611H1 <br /> Received Time Jan. 20. 2015 10 :54AM No, 7929 <br />