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IVED <br /> E E <br /> SANLJOAQUIN Environmental Health Department <br /> COUNTY-- Y4AY18 0jtPUBLIC RECORDS RELEASE APPLICATION <br /> Iareotncss grows 1j.,�AY' iN <br /> y1• � �� AIL Z/ �'�1 <br /> IT/8 �" r7 EHD LOG NUMBER. <br /> APPLICANT: Rebecca Natal BUSINESS/AGENCY:Advanced GeoEnvironmental,Inc <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP: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 5/18/2018 <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-)slcehd.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. qa"'� <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 2018 <br /> ENVIRONMENTAL FILE ADDRESS _t ND <br /> HEALTH DEPARTMENT <br /> FILES (Specific addresses only, address ranges will not be accepted) EHD USE ONL <br /> ❑X Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) ❑CONSUMER <br /> QX Other Cleanup Site(Non-LOP) 1 1300 E Louise Ave Lathrop <br /> Q Hazardous Waste kW <br /> /� (� l11AA DAIRY <br /> �X Tiered Permitted Facility 2 500 E Louise Ave Lathrop �r` p0� \ <br /> nX Aboveground Tank i�N 14M 4'A PeE�Ta) <br /> ❑X UST (Monitoring I Removal) ❑PWS <br /> Q Hazardous Materials 3 <br /> QX Spill/Release Response <br /> ATER QUALITY <br /> F1 Solid Waste Facility/Vehicle 4 <br /> F]Food Facility <br /> F]Pool I Spa ff30SITF MITIGATION <br /> F]Dairy 5 <br /> Q Land Use Application Sites <br /> Septic Pumper Truck I 6 E]HOUSING <br /> Yard/Chemical Toilets <br /> Wastewater Treatment Plant UPA <br /> Housing Abatement 7 AST I HM/HW <br /> Motel/Hotel <br /> F]Chicken Ranch/Dog Kennel CUPA <br /> Medical Waste Facility 8 UST <br /> Tattoo/Body Piercing ❑SOLID WASTE <br /> Waste Tire 9 <br /> Q Complaint <br /> F]Other(Please Specify): ❑ACCOUNTING <br /> 10 <br /> ***BOXED AREA-EHD USE ONLY*** <br /> (Q 12(p Ile• �,.��-1�.. r�w:�ie l,E�n-�tEr•e /ice' �� �' c�l�.^vie v`� �,e.t+a�� iI '-�.- <br /> 3 ' 2 <br /> ❑ Records provided by Staff-PPR Complete. staff Name: EHD 48-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />