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j.��tU 1r+�1 l'.UU 11VU1 <br /> r <br /> >r DA'f t RECEIVEEi SAN 0 EHD LOG NUMBER <br /> I � .IOAQUIN COUNTY <br /> 3-12017 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 186E East Hazelton Avenue, Stockton, CA 95285-6232 5 7 <br /> 12IiiI5(}*4KIM1'iL f EP&TH-phone: (209)468-3420 Fax: (209)464-0138 Web:www,sfgov,arglehd <br /> PEM41TiSE1RW-'E3 PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Rebecca Uat2l _ EUSINES8IAGENCY: Advanced GeoE vironmental <br /> ADDRESS: 837 Shaw Road CITYISTATEIZIP: Stockton CA 93215 <br /> PHONE (1): 209-467-1006 PHONE(2): 209Q23-7200 FAX OR E-MAIL: 209-467-1118 <br /> Please allow 10 business days from date of appllcation submittal for the records to be available. <br /> Staff will contact you to arrange an appolritment date and time to review the requested records, <br /> CHECK BOX TO EXPEDITE REQUEST-$139 FEE(CASH D HECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE —1 <br /> 1. list un to ton addresses In fhe,space bele el ct he typ {s)of files from the list below by cheoking the appropriate <br /> box(es), At least one file type MUST be selected. Fax to(208)46J-011-30.or mail to the addrees irldiGatgd above. Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be Processed the next business day. <br /> 2. For assistance 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 files exist An appointment for review will be confirmed approximately tan(10) <br /> days after receipt of application. The files will be hold 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 some applicant may require a$439 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5;00PM(EXCLUDING HOLIDAYS) <br /> Electronic information: E3 List [l Map- Description: <br /> Specific Date Range of Information Requested; From to <br /> ENVIRONMENTAL a �5 ti°5 • t{-S-)`7 <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES EHD USE ONLY <br /> UNDEROROUND TANK((JST) Street# Street Name City <br /> CLEAIJUP SITE(LC)P] C Moffat <br /> j� p 9 ry r COIiBIIAIER <br /> �THER CLEANUP SSTE(NoN-LOP) i 475 Moffat Blvd Manteca <br /> A2'41DCU9 WASTE <br /> DAIRY <br /> ©ATIERED FERNITTEQ FACILITY 266 Moffat Blvd Manteca <br /> BOVEGROUND TAW <br /> rUST (MONITOWNG I REMOVAL) � T �o��T PW& <br /> YoousMATEf§IALs "'13' a 469 Moffat Blvd Manteca <br /> ILJRELEASE RESPONSE <br /> (� <br /> Moffat <br /> ATER <br /> F1 SCI-100 WASTE FACILITY IVENICLE f 430 Moff15 IT a Toat Blvd Manteca Quinn <br /> ❑row FACILTY <br /> 0 POOL XSPAnow <br /> 392 Moffat Blvd Manteca <br /> ❑DAIRY <br /> i6--USE APF-LICAFION.SITES - <br /> SEPTIC PUMFER TALjCK I ❑HoueINO <br /> f1 <br /> YARD I CHEMICAL TOILETS <br /> WASTEWATER TREATMENT PUNT - C[JpA <br /> Il�HwSINO ABATEMENT 7 <br /> MOTELMOTEL <br /> CHICKEN RANCH I Doo KENNEL 111PA-1187 <br /> MEDICAL WASTE FACILITY e <br /> TATTOO/SODY PIERCINo <br /> ❑soOo VvAarE <br /> w. E T¢RE <br /> a <br /> CCNPLAINT <br /> ❑OTHER(PLEABE SPECIFY); ❑AccouNTINC <br /> 10 <br /> 1,190xED AREA-ED USE ONLY— <br /> hceived Tine-Mar, 31 _a2017 8 �AfV�,tto, 11 9 <br /> r• <br />