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10/22/2013 14:23 (FAX) P.0011001 <br /> I� <br /> !ME ,�iE ` <br /> imp SAN .IOAQUIN COUNTY EHD LOG NUMBER <br /> � Zd13 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> P dNMj SER�IG0one: (209) 488-3420 Fax: (209) 464-0138 Web: wwwsjgov.org/ehd ` <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Ally Colavita BUSINESS/AaeNCY: Advanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITYISTATERIP: Stockton /CA 195215 <br /> PHONE(1): 209-467-1006 PHONE(2): 209-483-3401 FACSIMILE: 209-467-1118 <br /> TENTATIVE*APPOINTMENT DATE: ASP Time: <br /> (Please allow 10 buoineca days from data o application submittal--Tantavve onty-muot be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUFYST-$125 FEE ASH O HECK ONLY)-REQUEST PROCESSED IN 3 BU 3 %SS D YS <br /> SIGNATURE OF APPLICANT l/3�/L A DATE I O 2 2 / <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street N Street Name cityUnit 1 <br /> �L 1• 550 Commerce Court Manteca odb' % <br /> Z• 3258 Lance Drive Stockton N unu <br /> Lov3- 7 North Teepee Drive M r <br /> 4. I�Yin r unit 3 \ <br /> 5 �tI <br /> 6. un4 H / <br /> 7. <br /> a. 171 unit 6 <br /> 9. <br /> ID. (]volt e <br /> Specific Data Range of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> x❑UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT M SOLID WASTE FACIL�n��",�HICL� ? <br /> X❑OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY D WASTE TIRE ,;� T!I'/�n5 4" �r�•� <br /> x❑UNDERGROUND TANK(MONITORINGIREMOVAL) El DOG KENNEL x❑DAIRY 1p.2545 <br /> D HAZARDOUS WASTE GENERATOR ElCHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> x❑MERE13 PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPERTRUCKIYARDICHEMICAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOUSPA 0 LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY 0 COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR RByiaw: MONDAY-FRIDAY S:OO Am-S:oOPM(EXCLUDING HOLIDAYS) <br /> 1. List up to ton addroseen In the apaco above. Select the type(&)of files from the Hat above by checking the appropriate <br /> box(ea). At least one file type MUST be aeleoted. Fax to(2091464-01313 or mall to the addreaa Indleated above. Addroaa <br /> ranges will not be accepted-for additional asslalance with file addresses,contact the EHD. Applications recolved 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 ton (10) <br /> days after receipt of application. The files will be held for a maximum of five business days for review. Appointments <br /> ahouid be achadulad accordingly. <br /> 3. A file that la actively being worked on by EHD staff may not be Immediately available for review. A now application may be <br /> aubmltted when the file la available. <br /> 4. Any RIG not returned In the same condition as raioaaad will be reorganised by EHD staff attha expense of the applicant <br /> Future file reviews by the same applicant may require a$126 deposit prior to review. <br /> D- 3 f0 d- <br /> 5 M � — <br /> 3 uh # oCwi <br /> -7 3.5 } <br /> EMD4eae SID b d_ to hsent <br /> / /ra OItZ) <br /> Received Time Oct. 22. 2013 2:20PM No. 4342 <br />