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Jan. 24 2006 4:53PM Ad ed Geohvironmental No- 0926 P. 2/2 <br /> DATE RECEIVED ' EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> - ENVIRONMENTAL HEALTH DEPARTMENT Z <br /> 600 East Main Street, Stockton,CA 95202-3029 <br /> 'AP1 i+ 7 2608 Telephone: (209)468-3420 Fax: (209)464-0138 Web:wwws' 0V 01 <br /> tPdVi;Dlda ` ' iE',l i" PUBLIC RECORDS RELEASE APPLICATIO <br /> Pr .,..,. <br /> APPLIE]SNTi Ally Coldvita BU81NE331AGENCY: Advanced GeoEnyirann,.tal <br /> ADDRESS: 837 Shaw Road Stockton CA <br /> PHONE(t): 209 467-1006 PHONE(2): 209 483-3401 FACSIMILE: 209 467-1118 <br /> TENTATIVE"APPOINTMENT DATE: Time: <br /> (Please allow 10 bUsInos6 days from data Of application submittal-•Tenfaiw.only-moat ba confirmed) <br /> E3 CHECK BOX TO EXPEDITE REQU T-$980(�0 FSJILCASH CHECK ONLY)•REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT / ti J DATE <br /> Electronic Information: ❑ List❑Map—Description: <br /> FILE ADDRESS EHD USE ONLY _ <br /> Street 8 Street Name _ ,,.._.,. Clry - - ❑ Unit a <br /> 2. IIW --.. Iva- <br /> vrilf _.. ,K/ LJ Unit 2 <br /> 3. 1 5 C -- /— 00 <br /> 4. 1)'7,Q wLOUnit3 <br /> 5. I c2 4q4 <br /> 6. .. ..— ... Unit4 ^/ <br /> 7. <br /> 8 ❑ unit 5 <br /> 9. <br /> .. .... . ------- Unit <br /> 10. <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT `��(OLIO WAS TE FACILITYIVEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) �F000 FACILITY -WAS <br /> TIRE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) ❑DOG KENNEL t]DAIRY <br /> AtXX�lX HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> 13 TIERED PERMITTED FACILITY O MOTELIHOTEL 11 PUMPER TRUOKIYARD/CHEM TOILETS <br /> TATTODIBODY PIERCING ❑POOLISPA ❑LAND USE APPUCAMN SITES <br /> O MEDICAL WA$TE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM-6:OOPM - EXCLUDING HOLIDAYS, <br /> 1. List up to ten addresses In the apace above. Select the type(s)of(Nes from the list above by checking the appropriate <br /> box(ea). At least one file type MUST be selected. Fax to(2091464.0138 or mail to the address jadIcated above Address <br /> ranges will not be acceptad—for additional assistance with file addresses,contact the EHD.Applications received after <br /> 3:00 pm will be processed the next bualnoaa 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 business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that is actively being worked on by EMD staff may not be immediately available for review. A new application may be <br /> submitted when the file is available. <br /> 4. Any fila 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$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> EHD"AS WEB WW2D07 <br />