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r <br /> 28/2015 09:02 OW) P.0011001 <br /> & EHDLOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> OCT 2015 ENVIRONMENTAL HEALTH DEPARTMENT (� <br /> SS 1868 East Hazelton Avenue, Stockton, CA 95205-6232 0 <br /> ENVIRONMENTALHEALfHlephone: (209)468-3420 Fax: (209)464-0138 Web: www.algov.org/ehd <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Jennifer Berjlklan BUSINESS/AGENCY?dvanoed GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITYISTATEIZIP- Stockton,CA 95215 <br /> PHONE (1): 209-487-1008 PHONE(2): 209-4833401 - FACSIMILE:209-467-1118 <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 /> ❑ CHECK BOX TO EXPEDITE REgUE CASH OR CHECK ONLY)-REQUEST PROCESSED IN INESS DAYS <br /> SIGNATURE OF APPLICANT DATE U <br /> Electronic Information: ❑ List 7FMap—Description: <br /> FILE ADDRESS <br /> Street# Street Nemo city EHD USE ONLY <br /> 1. 825 Navy Drive Stockton Civ`-f°f� a"`P <br /> 2. 1137 South Stockton Street Stockton Cttp�„�-[ �j)�R t! It / pit 1 <br /> 3. 1240 Navy Drive Stockton Ltte✓� , 4) C� n t 2 <br /> 4. 1145 Wesf Charter Way Stockton -leh- <br /> ! <br /> S. 939 West Charter Wev Stodkton nr fit3—(y)pfL� <br /> i 6. lA <br /> 7. � ( nI[4 <br /> 8. II' -1 . .SITE MITIGATION <br /> 9. <br /> 1D. nit 6 <br /> Specific Data Range of Information Requested: From to <br /> ��,,// ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> y <br /> LI--�/UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITYQ`S�OLID WASTE FACILITYNEHICLE <br /> I}!I�THER CLEANUP SITE(NON-LOP) ❑HOUsiRe ABATEMENT []y]*ASTE TIRE <br /> ❑1JNDERGROUND TANK(MONRORINWREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ROVEGROUND TANK ❑CHICKEN RANCHI DOG KENNEL C]WASTEWATER TREATMENT PLANT <br /> 7ARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TIERED PERMrfTED FACILITY - ❑ USPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING Q COMPLAINT/RESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:0015M(EXCLUDING HOLIDAYS) <br /> 1. list ur to ten addresses In the space above. Select the type(s)of files from the list above by checking the approprlata <br /> box(es). At least one file type MUST be selected. Fax to(2091464-0138 or mall to the address Indicated above. Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next business 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 H any EHD Tiles exist.An appointment for revlewwlll be confirmed approximately ten(10) <br /> days atter recelpt of application. The flies 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. ''BOXED AREA-EHD USE ONLY' <br /> oadrt CLe� t 0'5+ 1140 fk I131 5kodt M Q 114 Ls . A u'T 0 <br /> I(K Ckur tftLA. �jel m— 14 131 }live Nuw II 4 t A ll�lS <br /> �tWtP! [ow + �� A Q. y (. <br /> CO 7 z '-A Lto Nav LO 1 U01 <br /> ❑ Records provided by Staff-!'PR Complete.Staff Name: tOeb Gula un Q9L0`l5 %W)m v le r � <br /> Eno m-oe GLyy ii L'►'�. 5l0(, (;ti f9r toll�,nts ('7 iti�Tu1'flIt <br /> Received Time Oct, 28. 2015 8: 54AM No. 9891 (AX10737514AJLt0"l')nq eer11'45 <br /> to-,(Aa cod:MG2 vuz; "'.� JIr1. PQ.I-& Go.-t .u' (6v�t�ay73 nrt LtOW tlj;&a4aisk/' 1?H0 Nwn,Or. <br />