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f 04110/2015 13:1.5 �X) P.0011001 <br /> ASMIVE® EHD LOG NUM t <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> APR 10 2015 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: wWW.sjgov.org/ehd <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: William I ittle BUSINESS/AGENCY: Advanced GeDEnvironmental <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP: Stockton / CA / 95215 <br /> PHONE(1): 209-467-1006 PHONE(2): 209— FACSIMILE: 209-467-1118 <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> -30 (Please allow 10 buslneas days from data of application submittal.'Tentative only-must be congnnad) <br /> Q CHECK BOX TO EXPEDITE REQUEST-$12 FF E H OR LH�ONNLLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT 1p/tVn / X DATE <br /> Electronic Information: ❑ List El Map—Description: <br /> FILE ADDRESS EHO USE ONLY / <br /> Street rF Street Name city Unit <br /> 1 600 East Louise Ave Lathrop <br /> l L� <br /> 2. 5,kS [71 Unitz <br /> 3. 400 D'ArW Parkway LathrQp <br /> 4. <br /> S. 1 <br /> G 0-, <br /> 6. <br /> I - <br /> 6, 1 EUnit4 <br /> 7. <br /> g, 171 Unit 6 <br /> 9. <br /> 10. ❑.(rnit 6 <br /> Specific Data Range of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> x❑UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT M SOLID WASTE FACILnYNEHICLE <br /> x❑OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY E]WASTETIRE <br /> Q UNDERGROUND TANK(MONTORINGIREMOVAL) ❑DOG KENNEL El DAIRY <br /> O�HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> L=J TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCK/YARDICHEMICAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOLISPA M LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY 0 COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-6:00PM(EXCLUDING HOLIDAYS) <br /> 1. List uD to tan addressee In the apace above. Select the type(s)of files 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 Indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHp. 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 appointmentfor review will be confirmed approximately ten(10) <br /> days after receipt of application. The flies will be held for 9 maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A filethat 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 eame 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$125 deposit prior to review. <br /> EHO USE ONLY <br /> cwn nvnv <br /> 011111 <br /> Received Time Apr. 10, 2015 1 : 12PM No. 8510 <br />