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�■ 03/2012015 11:36 "7AX) P.0011001 <br /> ■ <br /> �■ E" IVE D <br /> ■ EHD LOG NUMBER . <br /> I ■ DATE RECEIVED � <br /> ■ n SAN JOAQUIN COUNTY <br /> NEAR 2 0 2015 ENVIRONMENTAL HEALTH DEPARTMENT ' <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �aVil�C�tEsh.-�wPi"I; TAll <br /> e�"hone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Re13eCCa Natal BUSINESS/AGENCY; Advanced GeoEnvironmental <br /> ADDRESS; 837 Shaw Road CITY/STATE/ZIP: Stockton / CA/ 95215 <br /> PHONE (1). 209-467-1006 PHONE(2); 209-623-7200 FACSIMILE: 209-467-1118 <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of appllcatio ubmittal- faffv only-must be confirmed) <br /> ❑ CHECK BOX TO DOPED U T- 125 FEE(GA CK ON -REQU PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICA DATE <br /> Electronic Information: ❑List❑ Map—Descrlption: <br /> FILE ADDRESS SHD USE ONLY <br /> Street 0 Street Name City Unit 1 <br /> 1. 4699 South Airport Way Stockton <br /> 2. 4847 th Airport YVay StocktonUnft 2 <br /> .31 4837 th Airport Way Stockt <br /> 4• Unita <br /> b. 4500 South Airport Way Stockton3 l�f <br /> 6. 1686 Lockhead Court Stockton D'Unit4 <br /> 7. <br /> 4�� <br /> s. *'Address lines 4 - 7: Only requesting to �� Unit <br /> 10 review UST and LOP/ LUST files' � ,;� � Il. <br /> ,Ef Unit 6 <br /> SpeciFlC Data Range of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> x❑ <br /> UNDERGROUND TANK(UST)CLEANUP SrrE(LOP) HOUSING ABATEMENT SOLID WASTE FACILIiYNEHICLE <br /> X❑OTHERCLEANUPSITE(NON-LOP) ❑FOOD FACILITY ❑X WASTE TIRE <br /> x❑UNDERGROUND TANK(MONrrORING/REMOVAL) ❑DOG KENNEL ❑x DAIRY <br /> x❑HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATERTREATrIENT PLANT <br /> x❑TIERED PERhMED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCK/YARDIC HEMICAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOUS PA LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY Q COMPLAINT RECORDS Q OTHER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8;00 AW5:0OPM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses In the space above. Select the type(s)of flle9 from the[let above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mall to the address Indicated 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 notlfy the applicant If any EHD files 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 /> 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 8125 deposit prior to review. <br /> EHD USE ONLY <br /> EH 0 48-00 ®H H 9 <br /> Received Time Mar. 20. 2015 11 : 33AM No. 8374 <br />