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i■ 10/1, It- <br /> E-�� (FAX) P.0011001 <br /> irDATE R C EHD LOG NUMBER <br /> N% 0,CT <br /> 11 <br /> 2016 SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ENVIRONMENTAL HEALTf$lephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> PERMiUSERUICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Erin ROttacker BUSINESSIAGENCY:Advanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Rd. CITY/STATE/ZIP: Stockton, CA 95215 <br /> PHONE (1); 209-467-1006 PHONE (2): FAX OR E-MAIL; erottacker@advgeoenv.com <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will con$ t you to arrange an appointment date and time to review the requested records. <br /> ❑ CHECK BOX TO EX E ITE RE EST $130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 SIESS DAYS <br /> SIaNATUREI,OF APPLICAN lit.- DATE 1l� l �p <br /> 1. List up to ten addreseea In the apace below. Select the type(s) of files from the list below by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to (209)464:QI38 or mail to the address Indicated above. Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next buslneas day. <br /> 2. For assistance In Identifying the nature and content of EHD records,please contact EHD at the number noted above. <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 $130 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 Informatlon Requested: From to <br /> FENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES EHD USE ONLY <br /> 71 UNDERGROUND TANK(UST) Street# Street Name City <br /> CLEANUP Srre(LOP) L]CONSUMER <br /> ®OTHER CLEANUP STE(NDN-LOP) 623 South Harrison Street Stockton �� <br /> ®HAZARDOUS WASTE DAIRY <br /> ®TIERED PERMfr'rED FACILITY <br /> ® / 641 South Harrison Street Stockton {�}'�'���/ � <br /> A0QVEQR0UND TANK <br /> UST (MONITORIN(3/REMOVAL) ❑PWS <br /> ®HAZARDOUS MATERIALS - 540 West Scotts Avenue Stockton � �,t <br /> ®SPILURELEASE RESPONSE 'V <br /> SOLID WASTE FACILITY/VEHICLE 4 WATER QUALITY <br /> FOOD FACILrrY <br /> POOL/SPA SITE MITIGATION <br /> DAIRY E <br /> ®LAND USE APPLICATION SITES <br /> HousINo <br /> SEPTIC PUMPER TRUCK/ E � /'J�,,/'� <br /> YARD I CHCMICAL TOILGTS �cc C� I —2 S._� 'n (Q V y 1 <br /> WASTEWATER TREATMENT PLANT 4'� / UPA <br /> HOUSING AEATEMENT 7 <br /> M OTSUHOTGL <br /> CHICKHN RANCH/DOG KENNEL CUPA•+OZ44AT <br /> B <br /> L MEDICAL WASTE FACILrrY <br /> f7 TATTOO/60DY PIERCING <br /> �SOLID WAer <br /> WASTE TIME p <br /> ®COMPLAINT <br /> OTHER(PLEA3E SPECIFY), ACCOUNTING <br /> 70 <br /> —*BOXED AREA-FHD USE ONLY— <br /> Received <br /> NLY —Received Time_Oct. 11, _2016_ 1 : 51PN-No, 0137 <br /> 0 Records provided by Staff-PPR Complete. Staff Name: ` <br />