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®@� IU1ZG1Zu1S U9:02 (FAX) P.00V001 <br /> s <br /> Is Q _ ® � <br /> ■°@ �4s' <br /> ®a SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> OCT 28 2015 ENVIRONMENTAL HEALTH DEPARTMENT 41 Au <br /> I. 1868 East Hazelton Avenue, Stockton, CA 95205-6232 41'�.-"` <br /> ENVIRONMENTALHEALTfl�laphone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Jennifer Berilklan BUSINESS/AGENCY.4dvanmd GeoEnvironmental <br /> ADDRESS: 637 Shaw Road CITY/STATE/ZIP: Stockton, CA 95215 <br /> PHONE (1): 209-487-1008 PHONE (2): 209-483-3401 FACSIMILE: 209-467-1118 <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will Contact you to arrange an appointment date and time to review the requested records. <br /> ❑ CHECK BOX TO FJO-EDITE REQUE CASH OR CHECK ONLY)-REQUEST PROCESSED IN INESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ L15tn Map—Description: <br /> FILE ADDRESS <br /> Street N Street Name City EHD USE ONLY <br /> 1. 825 Navy Drive Stockton <br /> 2. 1137 South Stockton Street Stockton Unit 1 <br /> 3. 1240 Navy Drive Stockton <br /> ❑ unit z <br /> 4. 1145 West Charter Way Stockton Unit 2H <br /> 5. 939 West Charter Wav Stockton , <br /> • 6. 'Unit 3 <br /> 7. / <br /> M Unit4 <br /> 8. . 51:TE MITIGATION <br /> 4. <br /> 10. 1 L; <br /> 'Unit 6 <br /> Specific to Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> r❑+�UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑v SOLID WASTE FACILrryNEHICLE <br /> �!QTHER CLEANUP SITE(NON•IOP) rl Housi sABATEMEur 1-*AE7FTIRE <br /> ©UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ©9BOVEGROuND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> Q'HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTEIJHOTEL ❑PUMPER TRUCK/YARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY OUSPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOO/600Y PIERCING Q�COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM•5:00PM(EXCLUDING HOLIDAYS) <br /> 1. WSt up to ten addresses In the space above. Select the type($)of files from the list above by checking the appropriate <br /> box(es), At least one flia type MUST be selected. Fax to(209)464-0138 or mall to the address Indicated above Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next business day, <br /> 2. For assistance In Identifying the nature and content of EHD records, please contact EHD at the number noted above. <br /> 3. The EHD will notify the applicant Ifany EHD81es exist. An appointment for review will be confirmed approximately ten(10) <br /> days ager recelpt 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 wiff be reorganized by EHD staff at the expanse of the applicant. <br /> Future file reviews by the same applicant may require a$130 deposit prior to review. 'BOXED AREA-EHD USE ONLY"' <br /> ❑ Records provided by Staff-PPR Complete-staff Name: <br /> eno m-ae mute <br /> Reeelved Time Oct, 28. 2015 8 : 54AM No. 9891 <br />