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Jan. 15, 2010 6:35PM Ar iced Geo Environmental No. 6294 P. 1 <br /> DATE RECEIVED —. <br /> BMWE1�11SAN JOAQU140644-01*38Web: <br /> AHD LOG NUMBER <br /> V ENVIRONMENTAL HE <br /> 2010 P 6,0 East Main St. Stoc <br /> Tele hone: (209 468-3420 Fax: (209) o /e <br /> ENVIRONMENT HEALTH PUBLIC RECORDS RELEASE APPLICATION 7 <br /> APPLICANT: ARTS DEICKE BUSINESS/AGENCY: ADVANCED GEOENVIRONMENTAL, TNC <br /> ADDRESS: 837 SHAW ROAD CITY/STATE/ZIP:STOCKTON, CA 95215 <br /> PHONE(1)- 209-467-1006 PHONE(2): 209-321-6497 FACSIMILE: 209-467-1116 <br /> 7'E'NrArIVE'APPOINTMENT DATE: Time: <br /> (Ploase allow 10 business days from date of application submittal•'Tentative only•must be confirmed) <br /> ECK BOX TO EXPEDITE REQUEST•$1 FEE(C�RSH OR CHECK ONLY) REQUEST PROCESSED IN 3 Q <br /> USINESS DAYS <br /> SIGNATURE OF APPLICANT t... DATEe,',"JANUARY 2010 <br /> Electronic Information: ❑List❑Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street* _— — Street Name Cay _ ❑Unit 1 <br /> 1. 2705 COUNTRY CLUB BOULEVARD STOCKTON <br /> _ l 1 Unit 2 <br /> 3. <br /> 4. <br /> n*. \ <br /> b. <br /> 8. <br /> nit 4 <br /> 7. _-...._. \ <br /> III!QIM <br /> 8. <br /> __.... . U D,Units <br /> 9. ._....._ <br /> ❑Unit 6 <br /> Specfic Data Range of Information Requested; From 1991 to 2009 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITY/VEHICLE <br /> ❑OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> {X]UNDERGROUND TANK(MowTORINGIREMOVAL) ❑DOG KENNEL ❑DAIRY <br /> ❑HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCK/YARD/CHEMICAL TOILETS <br /> ❑TATTOO/BODY PIERCING ❑POOL/SPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00pm(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the type(s)of flies 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 mail 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 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 available 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 reviews by the same applicant may require a$11S deposit prior to review. <br /> S. If you need further assistance,please contact Diane Martinez,at(209)468.3426. <br /> EHD USE ONLY <br /> E &77109 <br />