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09/1712013 17:19 • �> P.0011001 <br /> DARWEI SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> l 1r ENVIRONMENTAL HEALTH DEPARTMENT41 A <br /> �E 8 ��� 1868 Fast Hazelton Avenue, Stockton, CA 85205-6232, <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/iand y <br /> ENVIRONMENTAL HEALTH 1� <br /> PERMIT/SERVICES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Rebecca Natal BUSINESS/AGENCY: Advanced Geo Environmental <br /> ADDRESS: 837 Shaw Road CITYISTATEIZIP: Stockton / CA / 95215 <br /> PHONE(1): 209-467.1008 PHONE (2): 209-623-7200 FACSIMILE: 209-467.1118 <br /> TENTATIVE'APPOINTMENTDATE: ASAp Time: <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> ❑CHECK BOX To EXPEDITE EST $125 FEE(CASH OjVECK LY)-R QUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE '• / �. 3 <br /> Electronic Information: ❑ List❑ Map–Description <br /> FILE ADDRESS EHD USE ONLY <br /> street Stroal Nama - city <br /> unit 1 <br /> 1• 1201 N r AvenuejMM ocD/ <br /> 2• 1203 North Gertrude Avenue o kton \ 01 unk2 , <br /> 3 1275 North Gertrude Avenue sok on <br /> D 4• 1448 Shaw Road k n �, N Unk <br /> "L 6. 1282 Shaw Road Stockton <br /> �V C8 1113 Shaw Road Stockton 1� / nt4 1 <br /> T- 4343 East Fremont Street ES ock on a M T M <br /> 8- 4801 Nadottl Road S ock on / 11 Units <br /> g 1155 North v in No wo / <br /> 10. 1 L]i Unas <br /> Speclfic Data Range of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES p <br /> x[91 UNDERGROUND TANK(LIST)CLEANUP SITE(LOP) HOUSING ABATEMENT % l <br /> SOLID WASTE 0 y <br /> / <br /> %❑OTHER CLEANUP SITE(NON-LOP) Lj FOOD FACILITY e WASTE TIRE � Z <br /> Q UNDERGROUND TANK(MONITORINGIREMOVAL)r [:]DOG KENNEL El DAIRY 04j t — ` ZJ <br /> FHAZARDOUS WASTE GENERATORJ- El CHICKEN RANCH ❑WASTEWATERTREATMENT PLANT }Vt_A <br /> []TIERED PERMITTED FACILITY v�_ MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATTOO/9GDY PIERCINO H POOLISPA M LAND USE APPLICATION SITED <br /> ❑ MEDICALWASTEFACILIIY [71 COMPLAINT RECORDS ❑OTHER(PLEASESPECIFY) <br /> WELL AND SEPTIC PEIRMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-6:00FM(EXCLUDING HOLIDAYS) <br /> 1. List up to ton addresses In the apace above. Select the type(s)of files from the list above by chocking the appropriate <br /> box(ee). Al[seat one file type MUST be selected, Fax to(209)464-0138 or mall to the oddroee Indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after <br /> 3:00 pm will be proceseed the next bualneas day. <br /> 2. The EHD will notlf) n nI � Klmately ten(10) <br /> days after receipt /I -A eQ�� G ✓lP�< <2rl�tr�DieS Di` in[e`cQP/It polntments <br /> should be schedul (Ji-{#.'s x.55- Oi0-7z.(69r 3Fremoirt)d #0$1461 <br /> 3. A file that Is active -- Alcatlon may be <br /> submitted when th - uy•g q . Igo *Zpht7W_ 117 SGe4- �• <br /> a, Any file not return ' 5 b ha applicant. <br /> Future file revlewe 14u 15;ka,411 COJDOY'5471t5 n M1Vfilf2l at <br /> �a1 el 5/d//tro�hl rn - g r.-- Co0`c bk�3 <br /> -- ''in (%. Hwhie n 5100 s- &/- 4314 1 <br /> 2 6tlncwaii 1 �r <br /> IcIM.rS fog 4 4s, Fremonf aatirt <br /> eio�aoe ( 5 <br /> lo-11-13 rove c{,p G a wltlAt fp110W,ny rs , T d-I-M , <br /> Received Time Sep. IQ%41 rvo-05rfil� u3N3frj1n&'7 . &2j <br />