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1 0412512014 17:41 �AX) _ P�0Okl001 <br /> Ismu <br /> t, <br /> 10 <br /> ■ le`, 4U LOG NUI$t€iER- <br /> ■ DATE RE <br /> Ir RFCME SAN .JOAQUIN COUNTY,; <br /> ENVIRONMENTAL HEALTH DEPARTMENT '. <br /> APR 2014 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sigov.org/ehd< r 'r <br /> 1 <br /> EN RONMEPERIT/SERLS <br /> VIC S <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Rebecca Natal BUSINESS/AGENCY: Advanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITY/STATE/21P: Stockton / CA/95215 <br /> PHONE(1): 209-467-1006 PHONE(2): 209-623-7200 FACSIMILE: 209-467-1118 <br /> TENTATIVF*APPOINTMENT DATE: AfiAP Time: <br /> (Please allow 10 business days from date of appl Icatlon submittal-"Tentative only-must be colmin ned) <br /> ❑CHECK BOX TO EXPEDITE REQ It .$125 FEE(CA CK 0 L UEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT rC17 DATE <br /> Electronic Information: ❑Llst❑ Map—Descriptio : <br /> FILE ADDRESS EHD USE ONLY <br /> Street A Street Name City p Unit 1 <br /> 1. 300 West Pine Street Lodi oob P``r <br /> 2. 12 Church Street AV Lodi rl)P a:u unit2 <br /> 230 Elm Street Lodi <br /> �4 > 124 Elm Street Lodi ttk; Tc M AST C° Unit3 <br /> 5. 107 School Street Lodl us; �cccsp <br /> 6. Ej Unit <br /> 7. <br /> ILI Unit 6 <br /> 9. <br /> 10. 1 Ef unit 6 <br /> Specific Data Range of Information Requested: From all to y <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> x❑U NDERGROUND TANK(UST)CLEANUP SrrE(LO P) ❑HOUSINGABATETAENT x❑SOUDWASTEFACILITYNEHICLE �Ihs <br /> QOTHER CLEANUP SITE(NON•LOP) F]FOOD FACILITY OWASTETIRE �I C <br /> RI UNDERGROUND TANK(MONUDRINGIREJDVAL) ❑DOGKENNEL . <br /> DAIRY 1 .,�t� <br /> . I <br /> Q HAZARDDUS WASTE GENERATOR [7 CHICKEN RANCH ❑WASTEWATERTRFATMENT PLANT 5� <br /> 0 TIERED PERMITTED FACILITY ❑MOTEUH OTFL ❑PUMPERTRUCKNARDICHENCAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑PODLISPA D LAND USE APPUCATIONSITES <br /> ❑ MEDICAL WASTE FACILITY ❑x COMPLAINT RECORDS ❑OTHER(PtEASESPECIFY) <br /> W ELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-S:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses In the space above. Select the typs(s)of files from the Hat above by checking the appropriate <br /> box(as). At leant one Ne type MUST be selected. Fex t�(2091 4Fd-0138 or mail to the address Indicated above. Address <br /> ranges will not be accepted-for additional agalstance with file addresses,contact the EHD. 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 review will be confirmed approximately ten(10) <br /> daya atter receipt of application. The files will behold for a maximum of five business days for review. Appointments <br /> should be scheduler)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 retumed 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$126 deposit prior to review. <br /> S-`6 IA •V'AELd Ch 0�- VXSV LIE2 I `-�,T iA5tul,1, <br /> e o4e <br /> Received Tlm,e. APr. 25. 2014 5: 30PM No. 5904 <br />