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._ <br /> _ . P.001100106!26lZ013 10:36 %} i <br /> DATE RECEIVED EHD I~QO NUMBER <br /> _ SAN JOAQUIN COUNTY. <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> _ ., <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> 1UN 6, ralephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> PUBLIC'RECORDS RELEASE APPLICATION. <br /> APPLICANT: Rebecca Natal., BUSINESs1AGENCY: Advanced Geo Environmental <br /> ADDRESS: 837 ShaW Road CITYISTATE/ZIP: Stockton./CA/95215 <br /> PHONE(1): 209467-1006 PHONE(2): 209-623-7200 FACSIMILE: 209•-4671118 <br /> TENTATIVE`APPOINTMENT DATE: �,pP Time: <br /> (Please aliow 70 bttainosa days from data of application Subi- ranfa.tive only must be nunftrmad) �I <br /> ❑ <br /> CHECK BOX TO EXPEDITE UE T-$126 FEE C R C ON -REOUES`r FROCESSED IN 3 BUSINESS PAYS <br /> SIGNATURE OF APPLICAN DAA149(9- <br /> Electronic Infnrma#ion: ❑List[] Map-=DescriptioA: <br /> FILE ADDRESS. EHD USE ONLY <br /> Street# Street Name City Unit 1 <br /> 1- 1650 South EI Dorado St Stockton <br /> 2. 1717 South Center St 3a8 'Stockton unu2 <br /> 3• 36275 South Welty Road 4:57 TraCYL /J 1 <br /> 4. <br /> 6. 27� ! 1� �c ,l Urtlt 4 <br /> 7. <br /> 8, Unit S <br /> 1 q. r nit 6 <br /> Specific Data Range of information Raquestod: From all to <br /> ENVIRCNMENTALMEALTH DEPARTMENT FILES <br /> Q UNDERGRouND TANK(UST)CLEANUP SITE(46P) Q HOUSING ABATEMENT ❑x SOLiD WASTE FACiLITTIVEKICLE <br /> Q OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY []WASTE TIRE <br /> I]UNDEROPOUND TANK(MONITORINGiREMOVAL) ❑DOG KENNEL 0 DAIRY <br /> E]HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WAS EWATER TREATMENT PLANT <br /> x❑TIERED PERMi CD FACILITY ❑MOTELIHOTEL j PUNIFER TRUCKIYARDICHEMICALTmerS <br /> ❑TATTO0I13ODY.PIERCING ❑POOLISPA ©LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY d•COMPLAiNT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELLAND SUPTIC PERMIT RECORDS ARE AVAILABLE FOR Rmnw: MomoAY•FRIpAY 8:00 Alin-5:OOPIN EXCLUDING HOLIDAYS <br /> 1. List un to ten addresses In the space above.. Select the type(*)of files from the Ilst above by checking the appropriate <br /> box(ee). At least one flla type MUST be selected. A- 138 or mail to the addrees.IndicatQd jj2ve., Address <br /> ranges will not be accepted-.for additional assistance with fila addresses,contact the LH!). Application received after <br /> 3:00 pm will be processed the next business day. <br /> 2, The EHD will notify the applicant If any-EHb Mae exist. An appointment for review will be confirmed approxlmataly tan(10) <br /> days after receipt of application. The files will be held for a maximum of five business days for review. Appolntmente <br /> should be scheduled accordingly. I <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 5HD staff at the expense of the applicant. <br /> Future flle reviews by the same applicant rhay require a 4125 deposit prior to review. <br /> EHD USE ONLY <br /> EHD 40-08 6!1!11 <br /> . . ... .I T'_. I.._ �G 1)A10 10 . 37AhA hl„ 1AKA <br />