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F kx) P.0011001 <br /> ".t,+a1..07i:014 14:10 — <br /> EHD LOG NUMBER <br /> � EI 1 SAN .IOA(ZUIN COUNTY `y ([ 1 <br /> ,/y <br /> ENVIRONMENTAL HEALTH DEPARTMENT / <br /> f�AR Q 7 ZQi¢ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 ///►►► � ` <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov,org/ehd <br /> EN'VAONMENTAL HEALTH <br /> n' 0"ITISEFMCES <br /> PUBLIC RECORDS RELEASE APPLICATION tj a <br /> r7./1 rnnY S� Et USINESSIAGENCY: Advanced GeoEnvlronmental <br /> APPLICANT.— <br /> ADDRESS: <br /> Stockton /CA/95Z15 <br /> ADDRESS: 837 Shaw Road ct FACSIMILE: Dna4R7-111 A <br /> PHONE (1): 209-467-1006 PHONE(2y.;�Qg ��9'3z 3 t-- Time: <br /> TENTATIVE'APPOINTMENT DATE: ^�" — <br /> (Please allow 10 business days from date of application submittal- Tentative only must be confirmed) <br /> CHECK BOX TO IXPEDITE REQUE -$12 FEE CASH O CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT BATE <br /> Electronic Information: ❑ List❑Map— Description: <br /> FILE ADDRESS EHD USE ONLY <br /> o � Stmet# Stmet Name City adnit1 <br /> Trot She 1. jKIV4 Cl B VIO LDS US MM CLSP <br /> 2. GITT gfN Q/Uf eo-w�wl1 ja�Unft .� <br /> 3. <br /> 4. E3UnR3 <br /> VSA 5. <br /> g, nit4 <br /> 7. <br /> 8. Unit 6 <br /> 9. <br /> 10. — "U ts <br /> specific Date Range of Infommtlon Raquastad: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ©UNDERGROUNDTANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT EISOUDWASTEFACIUNNEHICLE <br /> x❑ ON- t,� <br /> OTHER CLEANUP ❑FOOD FACILITY ❑x WASTETIRE <br /> 7x UNDERGROUND TANK(MONITORINWREMOvAL) [-I DOG KENNEL DDAIRY 3 <br /> ❑HAZARDOUS WASTE GENERATOR C]CHICKEN RANCH - ❑WASTEWATERTREATMENTPLANT <br /> Z TIERED PERMITTED FACILfry ❑MOTELMOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATMOIBODY PIERGNG ❑POOUSPA x❑LAND USE APPLICATION SITES <br /> ❑ MEDICALWASTE FACILITY O COMPWNT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY S:OO AM S:OOPM(EXCLUD(NG HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the type(a)of files from the list above by checking the appropriate <br /> box(es). At least one filo type MUST be selected. Fax to(209)464-0138 or mall to the address Indicated above. Address <br /> ranges will not be accepted-for additional assistance with File addresses,contact the FHD. Appl Ications recelved sffer <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 ovallable. <br /> 4. Any file not returned In the same condition ea released will be reorganlmd by EHD staff at the expense of the applicant <br /> Future file reviews by the same applicant may require a$126 deposit prior to review. <br /> 3-)t-1- PrDyIdg6 alwi CFtnil- <br /> EHD4sae uvit <br /> Received Time Mar. 7. 2014 2:OOPM No. 5370 <br />