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03106/2015 15:05 P.0011001 <br /> � � �� , END LOG NUMBER <br /> ■ <br /> ■ �' SAN JOAQUIN N Y <br /> iMAR 0 9 2015 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Ir 1 <br /> ENVIRONMENT AL HEATL�N phone: <br /> _NVIRONMEN TALHEATL�Nphone: (209)468-3420 pax: (209)464-0136 Web:www.sjgov.org/ehd <br /> '•= NIMSERVICES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Jennifer Bedikian BUSINESS/AGI-NCYAdvanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP:Stockton,California 95215 <br /> PHONE(1): 209-483-3401 PHONE(2): 209-467-1006 FACSIMILE:209.467-1118 <br /> TENTATIVE"APPOINTMENT DATE: Time: <br /> (Please allow 10 buslnesd days f e of application submittalm <br /> -"Tenradve only-must be confiwd) <br /> ❑ CHECK BOX TO EXPED E -$125 FEE( H OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSIN Df$ <br /> SIGNATURE OF APPLICAN DATE i <br /> Electronic information: ❑ us Map—D rlptlon: <br /> FILE ADDRESS EHD USE ONLY <br /> Street 0 Street Name City E Unit 1 <br /> 1. 1730 Ackerman Drive Lodi <br /> 2. 1702 Ackerman Drive Lodi �lnft2 - <br /> 3. 1723 Ackerman Street Lodi <br /> 4. �7 <br /> Unit 3 <br /> 15. <br /> 6. i Unit 4 <br /> 7. <br /> 6, <br /> Unit B <br /> 9. <br /> 10. L3'Unit e <br /> Specific Date Range of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> x❑ <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑x SOLID WASTE FACILITYNEHICLE s <br /> x❑OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY Q WASTE TIRE <br /> UNDERGROUND TANK(MONITOMWREMOVAL) ❑DOG KENNEL Q DAIRY <br /> x❑HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> Q TIERED PERMITTED FACILITY ❑MOTEUHOTEL ❑P LINPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATTODIBODY PIERCING ❑POOIJSPA 0 LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITYx❑COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PUMT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 6:00 AM-5:OOPM(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 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 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 bualness 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 new appllcatlon 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 END staff at the expense of the applicant: <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. <br /> EHD USF,ONI.Y <br /> FHD 4aD@ afiN1 <br /> Received Time Mar. 6. 2015 3: 04PM No, 8279 <br />