Laserfiche WebLink
1111012015 15:27 (FXX) P.0011001 <br /> �, 7Tx EC Fl-1D LOG NUMBER <br /> SAN JCiAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> NOV a 0 20151868 East Hazelton Avenue, Stockton, CA 95205-6232 �1 <br /> )` 1/Telephone: (209)458-3420 Fax: (209)464-0138 Web:www,sjgov.org/ehd <br /> ENVIRONMENTAL 'r IC ��j ECC�4Oh C{�) E/�S APPLICATION <br /> ¢q `` [A`S'EE NF`f <br /> WPfl, <br /> L��nrrti�nTnncRRT ��i��E� f\G6rV {� �E�GY►�7� M���I /111 fV <br /> APPLICANT: Jennifer Berjiklan BUSINESS/AGENCY:Advanced GeoEnvironmental <br /> ADDRESS: 837 Shav:Rood CITY/STATE/ZIP:Stockton,CA 95215 <br /> PHONE(1): 209-467-1006 PHONE (2): 209-483-3401 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 annaappointment date and time to review the requested records. <br /> ❑ CHECK BOX TO EXPEDITE uE -$130 F2 {CASH OR CHECK ONLY)-REOUEST PROCESSED IN 3 USINESS DAYS <br /> SIGNATURE OF APPLICAN ^. DATE 1117/ 4 <br /> v <br /> Electronic Information: ❑ List Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City �' <br /> 1. 213 South Kelly Lodi ft\ /110 <br /> y, 214 South Kelly Lodi <br /> Unit 1 <br /> 3, 224 South KellyLodi �n Urtlt2 <br /> 4. 77 South Cluff Lodi <br /> Unit 2H <br /> 5 4851 East Lodi Avenue Lodi <br /> f)z ; <br /> 6. <br /> 7 D-Onk 4 <br /> 8. <br /> _ S!M%1MOATION <br /> 9. <br /> 10. aUnit 5 <br /> Sptclflc Date Range of Information Requested. From to <br /> /, ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> Q UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY / <br /> SOLID WASTEACILTTY EHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑HOUSINO ABATEMENT M'WASTE TIRE IN P1,f'S '�C <br /> Q UNDERGROUND TANK(f1!ONITORINO/REMOVAL ©FOOD FACIL" ❑DAIRY -I (� � i).Z3-L5 <br /> ABOVEGROUND TANK' ❑CHICKEN RANCH/DOG KENNEL <br /> ❑HAZARDOUS VVASTEIHAZARDOUS MATERIALSV ❑MOTELINOTEL 0 PUMP E�:ATER TREATMENT ICAL <br /> TOILETS❑FUMPERTRUCKJYARDICHEMICAL <br /> ©TIERED PERMITTED FACILrrY [l POOLISPA E14ND USE APPLICATION SITES <br /> ❑TATTOO/Gores PIERCING Q COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> 1. Llzt up to ten addresses In the space above, Select the type(s)Of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to f209)464.01"s8 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 aAslstance 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 if any EHD tiles 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$130 deposit prior to review. "*BOXED AREA-1171-111)IISF ONLY" <br /> ❑ Records provided by Staff-PPR Complete. staff Name: <br /> END 448.08 <br /> " 7HH6 <br />