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■ <br /> 0310612015 15:05 tp"X) P.0011001 <br /> ■ <br /> REC <br /> ■ <br /> ■■ <br /> OV SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> MAR O 9 2015 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ENVIRONMEt,1TALHFATr-.�iphone: (209)468-3420 pax: (209)464-0138 Web: www.sjgov.org/ehd %DV <br /> PERI ITISERVICES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Jennifer Belikian BUSINESS/AGENCYAdvanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITY/STATEIZIP:Stockton,California 96215 <br /> PHONE(1): 209-483-3401 PHONE (2): 209-467-1006 FACSIMILE:209-467-1118 <br /> TENTATIVE"APPOINTMENT DATE: Time: <br /> (Please allow 10 buslne3a days f of application submittal-"Tenfarlw only-must be confirmed) <br /> ❑CHECK BOX TO EXPED E -$125 FEE( .SH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSIN- fS <br /> SIGNATURE OF APPLICAN DATE i <br /> Electronic Information: ❑ Lls Map—D riptlon: <br /> FILL=ADDRESS EHD USE ONLY <br /> Street# Street Name City Unit 1 <br /> 1. 1730 Ackerman Drive Lodi A <br /> 2, 1702 Ackerman Drive Lodi �11= Unit 2 <br /> 3. 1725 Ackerman Street Lodi <br /> _ �? <br /> Z'5 4 Unit 3 <br /> v t< <br /> t� 6. i ���`lae� Me" ti��� .Unit <br /> 7 e <br /> inn <br /> 8. I :� Unit 5 <br /> 9. <br /> 10. <br /> L-3'(JnR 8 <br /> Speclfic Date Range of Infonnadon Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> X1 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑x SOLID WASTE FAGLITYNEHICLE <br /> x❑OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY WASTE TIRE <br /> D UNDERGROUND TANK(MCMTORING/REMOVAQ ❑DOG KENNEL Q DAIRY <br /> 0 HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑MOTEUHOTEL ❑PLWER TRUCKIYARD/CHEMICAL TOILETS <br /> ❑TATTOO/BODY PIERCING ❑POOL/SPA Q LAND USEAPPIICATION SITES <br /> ❑ MEDICAL WASTE FACILITYx❑COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 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(2091464-0136 or mall to the address Indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact ttte 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 flies 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 EHD staff may not be Immediately avallable for review. A new 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 EHD staff at the expense of the applicant. <br /> Future file reviem by the same applicant may require a$125 deposit prior toreview.review. <br /> -Pete t /�-5 -iCe�., � L D .Y Vv.J�,,l (A �11e- V'lN <br /> L'Mo 4s� Eli/11 <br /> Received Time Mar. 6. 2015 3.04PM No. 8279 <br />