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0311612011 08:39 Advanced GeoEnviromental Inc. IF0209 4671118 P.0011001 <br /> HAM�q <br /> y d lNHa d • EHD LOG NUMBER <br /> INNOL IAN3 SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT \o4f'7 <br /> 1104 9 I VIN 600 East Main St, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209) 464-0138 Web:www.sjgov.org/ehd <br /> 03/ oI303U. PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Ally C:olavita BUSINESS/AOENGY:Adiy n(`sad G9cIFnyirnnmPnta1 <br /> ADDRESS: 837 Shaw Egad CITY/STATEOP: Stockton/CA/95215 <br /> PHONE(1): 209-467-1006 PHONE(2):209-483-3401 FACSIMILE: 209-467-1118 <br /> TENTATIVE'APPOINTMENT DATE: near Time: <br /> (Please allow to business days from date of application submittal••7bnta9ve only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUq$T-$1 FEE A H OR CHECK ONLY)-REQUEST PROCESSEU IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT (/J�/ 7i a DATE 1/1(,(U <br /> Elsctronlc Information: ❑List❑Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> StrwtM Street Name city Q Unit <br /> .2148est Mari .oso. __S�nzh . _- 0 <br /> n, 2• x.g . _ tc <br /> 4. its /f l <br /> 6. <br /> 8. nit4 <br /> 7. <br /> S. D Units <br /> 9. <br /> 10. nit e <br /> Specific Date Range of information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(LIST)CLEANUP 3n(LOP) ❑HOUSING A9ATEMENT ®SOLID WASTE FACILRYfVEHICLE 6'GJ <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ®WASTE TIRE <br /> ®UN05ROROUND TANK(MONNORINOIREMOVAV ❑DOG KENNEL ❑DAIRY <br /> W HAZARDOUS WASTE GENERATORS ❑CHICKEN RANCH ®WASTEWATER TREATMENT PLANT <br /> ®TIEREDPERMITTED FACILITY O`. []MOTELIHOTEL ❑PUMPER TRUCKNARDICHEMICALTOILET$ <br /> ❑TATTOOISODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ® MEDICALWASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILA13LE-FOR REVIEW: MONDAY-FRIDAY 6:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. Llai ub to ten addresses In the apace above. Select the type(s)of fllea from the(hat above by checking the appropriate <br /> bax(ea). At feast one file type MUST be selected. Fax to(2091484.07 as or mall to the addreaa indlcatsd 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 processed the next business day. <br /> 2. The EHD will notify the applicant If any EHD filea exist. An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The filea will behold for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be Immediately available for review. A now application may be <br /> submitted when the file is available. <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$115 deposit prior to review. <br /> 5. If you need further assistance,please contact Diane Martinez,at(209)458.5425. <br /> IkAl END use NLY <br /> Z� 1 <br /> tf 4 r Do <br /> d QQ <br /> IUga_e 1-111\161'P <br /> r S 10b . r,9ae <br /> END 4645 �r Z1806 MCKr,�75GC,L�(ui�i�� � <br />