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o❑ 01/22/2015 16:07 (FAX) P.0011001 <br /> I ❑ <br /> I ❑ <br /> 11 13 r3❑❑ DATE RECEIVED EHD LOG NUMBER <br /> r ; <br /> SAN JOAQUIN COUNTY <br /> ❑ N � 017 �V ED ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 ca <br /> JAN 2 3 201belephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: RebeCCa Natal BUSINESSIAGENCY:AdvancedQeoEnViron Mental <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP:Stockton /CA/95215 <br /> PHONE (1): 209-467-1006 PHONE(2):209-623-7200 FACSIMILE: 209-467-1118 <br /> TENTATIVE`APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-•Tantstive only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE RE $12b FEE( CHC -REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE. -/� <br /> Electronic Information: ❑ List❑ Map—Desorlptlon: <br /> FILE ADDRESS EHO USE ONLY <br /> Street# Street Name City -Unit 1 <br /> 1. 1947 Eiast Channel Street StoCkton 1(� �J <br /> 2• 1950 Min r Av - UnIt2 <br /> 3. 2150 East Fremont Street Stockton -10\- <br /> 4• 103 North E Street Stockton El uit3 <br /> 5- 36 D Street Stockton <br /> 6- 124 North E Street Stockton ❑linit4 <br /> 7• 11 South A Street Stockton <br /> e• 1750 East Channel Street Stockton Q Units <br /> 10, r JtG <br /> Specific Date Range of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> x❑ <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT SOLID WASTE FACILRYNEHICLE <br /> ❑x OTHER CLEANUP SITE(NON-LAP) ❑FOOD FACILITY ❑x WASTE TIRE <br /> D UNDERGROUND TANK(MONITORINGIREMMAL) ❑DOG KENNEL FX1 DAIRY <br /> ❑x HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> Q TIERED PERNMED FACILITY ❑MOTEUHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATIOOMODY PIERCING ❑POoLI&PA x❑LAND USEAPPUCATION SITES <br /> ❑ MEDICAL WASTE FACILITY Q COWLAINT RECORDS Q OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-6:DOPM(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(209)484-4138.or mall to the address indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Appllcatlons 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 atter receipt of application. The flies 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 now 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 some applicant may require a$126 deposit prior to review. , <br /> EHE` Y.�. <br /> �.°� <br /> 1 -06 E11111 <br /> Received Time Jan, 22, 2015 3:59PM No• 7944 <br />