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SAN JOAQUI I�CEIVED Environmental Health Department <br /> —COU I`ITY--APR O 3 ZO`i$ PUBLIC RECORDS RELEASE AP LIICCjATION <br /> • - "' ` 'ENVIRONMENTAL V <br /> - 6AN�`rfBY EMAIL <br /> PERMITIISERIIIF,FF�� EHD LOG NUMBER: <br /> APPLICANT: Rene Toth BUSINESS/AGENCY:Advanced GeoEnvironmemd <br /> ADDRESS: 637 Shaw Road CITYISTATEOP:Stockton,California <br /> PHONE(1): 20SA67.1006 PHONE(2): FAX OR E-MAIL: noth@advgeoenvoom <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact . u to a.ral�g an p of tment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT /� DATE 04/012016 <br /> 1. List up to ten addresses int W c b o . 1Ad reft r nges WILL NOT be accepted. Select the type(s)of files from the <br /> list below by checking the ap ropfiate box(es). At least one file type MUST be selected. Fax to(209)464.0138,mail to the <br /> address indicated below,or email to info(dsicehd.com. Applications received after 3:00 pm will be processed the next <br /> business day. <br /> 2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted below. <br /> 3. The EHD will notify 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 /> 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$152 deposit prior to review. r <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map–Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT (Specific y 9 p ) EHD USE ONLY <br /> FILES addresses only,address ranges will not be acre ted <br /> nx Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) ❑CONSUMER <br /> • ONer Cleanup Site(Non-LOP) <br /> 1705 N Broadway Avenue Stockton <br /> Z Hazardous Waste ❑DNRY <br /> nXX Tiered Permitted Facility 2 _ <br /> ❑x Aboveground Tank Uht LO <br /> ❑x UST (Monitonng l Removal) ❑PWS <br /> QX HHazardous Materials 3 <br /> Q Spill l Release Response r J I n Irl, ATER QMn` <br /> Solid Waste Facility/Vehicle 4 <br /> ❑Food Facility GD <br /> SnE MmaA'nox <br /> Pool/Spa <br /> Dairy <br /> 5 <br /> Q Land Use Application Sites <br /> [3 Housixe <br /> E]Septic Pumper Truck/ a <br /> Yard r Chemical Toilets <br /> ❑Wastewater Treatment Plant RICUPA <br /> ❑Housing Abatement 7 ASTlHM/HW <br /> MolellHotel <br /> ❑Chicken Ranch/Dog Kennel <br /> e UST <br /> Medical Wasta Facility <br /> Talboo/Body Piercing ❑$DOD WNSM <br /> ❑Waste Tire 9 <br /> ❑X Complaint <br /> n Other(Please Specify): ❑AccaDnnxO <br /> 10 <br /> ""BOXED AREA-EHD USE ONLY'"* <br /> • 77-1 )- I(f n irn CGie ^ A ' .- -I c CtAl t.A' I Ove tl Uohn <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: EHD naris <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />