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Ifill 0411012015 2/ ' 13:1.5 SAX) P.0011001 <br /> 1 CEIVED <br /> EHD LOG NUM R <br /> f{ <br /> � SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> APR 10 2015 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: William Little BUSINESS/AGENCY: Advanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP: StaoktOn / CA / 95215 <br /> PHONE(1): 209467-1006 PHONE (2): 209- FACSIMILE: 209-467-1118 <br /> S�y� TENTATIVE'APPOINTMENT DATE: Time: <br /> !!�� ��'' (Please allow 10 business days from data of application submittal-'Tentative only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST•/x$12 F E(CASH OR ONLY)-REQUEST PROCESSED IN 3-BUSINESS DAYS <br /> SIGNATURE OF APPLICANT P/(/ A G� /� DATE <br /> Electronic Informatlon: ❑ List❑Map—Description: <br /> FILE ADDRESS EHD USE ONLY / <br /> Street9 Street Name City <br /> 1. lwt <br /> East Louise A H�-�wLO A <br /> 2• UnIt2 <br /> 3. 400 1 Parkway LathropIvt F I <br /> 4. NC F unit3 �1 <br /> S. <br /> 6. EI UnR4 <br /> T' )e9a� 00 aey W Litt CD <br /> B• V� 0 Unit <br /> 10. p:Snit S <br /> Specific Data Flange of Informatlon Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ❑x UNDERGROUND TANK(USTI CLEANUP SITE(LOP) ❑HOUSING ABATEMENT x❑SOLID WASTE FACILIIYNEHICLE <br /> R1 OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑x WASTE TIRE <br /> x❑UNDERGROUND TANK(MONrTORINGIREMOVAL) ❑DOG KENNEL ❑x DAIRY <br /> R1 HAZARDOUS WAGTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY ❑MOTELMOTEL ❑PUMPER TRUCKNAROICHEMICAL TOILETS <br /> ❑TATTOOISODY PIERCINO ❑POOLISPA - ❑x LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑x COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY B:00 AM-5:QOPM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses In the apace above. Select the type(s)of files 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 Indicated abstvo. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHp. 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 exist. An appointment for revlewwlll 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 la 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 applicant may require a$125 deposit prior to review. <br /> (.JJej C_13 1 % z L A)k4 "40( , 570 I a,age*Al"ONLY <br /> o whit Ow3l SS (.(J vot71777 I-fu% r� E¢ Ilr_ W/- 00 v <br /> CL%,ii C vf7 J 107 o,,, CO rk7 2Ga90 Are 4LP- LA5T n1e for e Ave: <br /> cwn aa�n 5/1111 <br /> Received Time Apr. 10, 2015 1 : 12PM No. 8510 <br />