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RECEIVED <br /> SAN J O A Q U I N Environmental Health Department <br /> ---- C C U N T Y -- MAY 18 2-011 PUBLIC RECORDS RELEASE APPLICATION <br /> FWf� I MAIL i�w, ��15 <br /> • Z1 P14 EHD LOG NUMBER: 13 <br /> APPLICANT: Rebecca Natal BUSINESS/AGENCY:Advanced GeoEnviron mental,Inc <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP:Stockton,CA 95215 <br /> PHONE(1): 209-467-1006 PHONE(2):_109-623-7200 FAX OR E-MAIL: Rnatai@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 s ixz018 <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(c-)sicehd.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. <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 _-1: to 2018 <br /> ENVIRONMENTAL FILE ADDRESS -I_DVb <br /> HEALTH DEPARTMENT (Specific addresses only,address ranges will not be accepted) EHD USE ONIFILES <br /> ❑x Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) ❑CONSUMER <br /> QOther Cleanup Site(Non-LOP) ' 1300 E Louise Ave Lathrop <br /> Hazardous Waste d-l'y✓ ( /� may, DAIRY <br /> Q Tiered Permitted Facility z <br /> 500 E Louise Ave Lathrop G, l� 1 <br /> Q Aboveground Tank <br /> FX UST (Monitoring/Removal) ❑PWS <br /> Q Hazardous Materials 3 <br /> Q Spill I Release Response <br /> ATER QUALITY <br /> F]Solid Waste Facility/Vehicle 4 <br /> Food Facility <br /> F]Pool/Spa W6MITIGATION <br /> Dairy 5 <br /> 0 Land Use Application Sites <br /> ❑HOUSING <br /> Septic Pumper Truck/ 6 <br /> Yard/Chemical Toilets <br /> F1 Wastewater Treatment PlantUPA <br /> F] Housing Abatement 7 AST/HM/HW <br /> Motel/Hotel <br /> Chicken Ranch/Dog Kennel [v3 CUPA <br /> 8 UST <br /> ❑Medical Waste Facility <br /> ❑Tattoo/Body Piercing ❑SOLID WASTE <br /> ❑Waste Tire 9 <br /> Q Complaint <br /> Other(Please Specify): ❑ACCOUNTING <br /> to <br /> ***BOXED AREA-EHD USE ONLY... <br /> hle',.��k1' <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 209464-0138 1 www.sjcehd.com <br />