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Aug. 18. 2005 6:43PM A4ced GeoEnyironmental . No. 1162 P. 1 <br /> DATE RECEIVED EHD LOG NUMBER <br /> R <br /> ((�� �� SAN JoAQuuv COUNTY <br /> W E� W U F DD ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 But Weber Avenue,3rd Floor, Stockton,CA 95202-2708 <br /> 61(r, x 1) 2005 Telephone: (209)468-3420 Faz: (209)464-0138 Web:WWW.sjgov.org/ehd 19 <br /> ENVIRONMENT I1EALTH . PUBLIC RECORDS RELEASE APPLICATION q45 <br /> APPLICANT:/bLI uzanne Henderson BUSINE8SIAGENCY: Advanced GeoEnvironmental, Inc. <br /> ADDRESS: 837 Shaw Road,Stockton CA 95215 <br /> PHONE(1): 209-467-1006 PHONE(2)): /Coll:209-712-2278 ' FACSIMILE: 209-06-7-111188 <br /> TENTATIVE'APPOINTMENT DATE: o?I/ !�- V4& wto,'S Tim: /D '60 reQJ/Ien <br /> (Please allow 10 burin ys from date Of appl" ion submittal-•Tenmtire Only.moat tre confirmed) O <br /> M CHECK BOX TO EXPEDITE QUE$ -;93.00 FEE(C H R CHE K ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE BS_ <br /> UNITDISTRIBUTION 13 Unit t Unit2 nR3 XnIt4 OUnit s Q Unit 11 Other(electronichia nape) <br /> FILE ADDRESS EHD USE ONLY <br /> Street 0 Street Name CRY <br /> I <br /> . CI !Ot^ Q C 0 <br /> 07D5'0 n !n <br /> 8. <br /> 9. <br /> 10. <br /> Specific Date Range of Information Requested.Fir _ = to <br /> EWIRONME AL HEALTH DEPARTMENT FILES <br /> W UNDERGROUND TANK JUST)CLEANUP SITE(LOP) Cl HOUSING ABATEMENT Q SOLID WASTE FACILITYNEHICLE <br /> IQ OTHER CLEANUP SITE(NON-LOP) OFOOD FACILITY QWASTE TIRE <br /> W UNDERGROUND TANK(MOMTORINOIREMOVAL) O DOG KENNEL Q DAIRY <br /> •HAZARDOUS WASTE OENERATUR Q CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT <br /> O TIERED PERMITIM FACILITY O MOTELMOTEL 0 PUMPER TRUCKfYARD(CHEM TOILETS <br /> O TATTOo(BODY PIERCING ❑POOL(SPA X LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY d OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR RENEW- MONDAY-FRIDAY 8:00 AM.S:00PM - EXCLUDING HOLIDAYS. <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address <br /> Indicated above. Address ranges will not be accepted–for additional assistance with file addresses,contact <br /> the EHD.Applications received after 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 <br /> approximately ten (10)days after receipt of application. The files will be held for a maximum of five business <br /> days for review. Appointments 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 new <br /> application may be 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 <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> r� 8 <br /> SHO"2-0 <br /> U140 <br />