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1110512010 1(7:222 Advanced G E viromental Inc. SAH)2094671118 P.0011001 <br /> EHD LOG NUMBER---Y ° SAN �IOAQUIN COUNTY <br /> NAV S 2�1a ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202-3029 t <br /> f�f_t �C� Is ew\vw,.sjgov.org/ehd <br /> (209)468-3420 Fax: (209) 464-0138 Web:w\v .sjgov.Grg/ehd <br /> P PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Ally Colavita BUSINESS/AGENCY:Advanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITY/STATE2IP: Stockton, 95215 <br /> PHONE(1): 209-467-1006 PHONE(2): 209483-3401 FACSIMILE: 209.467-1118 <br /> TENTATIVE*APPOINTMENT DATE: '45 Time: <br /> (Please allow 10 business days from date of■ppllaatlon submittal-*rbntativa only-must be confirmed) <br /> ®CHECK BOX TO EXPEDITE REQUEST-$122 FEE('COR �ECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS, <br /> SIGNATURE OF APPLICANT DATE 1115-/1 o <br /> Electronic Information: ❑ List❑Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Stroote Street Name City _ 12 El Ush-V <br /> lu ? <br /> 1• 2. t 5 e. o U5 1 d C c(/ <br /> 3. 2 au f1tK A7u Noc I�II� <br /> 4. z aGi 'c vt � U c4 h tilts <br /> 8• 7303 Fa , tc Ave- " 5 a nit4 <br /> 7. <br /> 8. nit e <br /> 9. <br /> 10. rite / <br /> SpaclNe Data Range of Informatlan Requnted: From to I g l <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES Y <br /> X❑UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ®HOUSING ABATEMENT SOLID WASTE FACIUTYIVEHICLE . <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY WASTE TIRE <br /> ®UNDERGROUND TANK(MONITORINOIREMOVAL)K ❑DOG KENNEL ©DAIRY <br /> ®HAZARDOUS WASTE GENERATOR IK. ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ®TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ©TATTOOISODY PIERCING ❑POOL/SPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILA91.E FOR RSyiew: MONDAY-FRIDAY 8:00 ANI-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List ug to ten addresses In the space above. Select the type(*)of files from the flet above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to 22114640136 or mall to the address indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addrasses,contact the EHD. Applications received attar <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant If any EHD ales exist. An appointment for review will be confirmed approximately tan(1 O) <br /> days after receipt of application. The Sea will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that Is actiyely being worked on by EHD staff may not be Immediately available for review. A new application may be <br /> submitted when the file la avaliable. <br /> 4. Any Nle 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$122 deposit prior to review. <br /> END USC ONLY <br /> - qOO M11 <br /> S , [1 100WJ-69 <br /> zlo 5 <br /> tr d <br /> CHO 49-05 07/29110 <br />