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SAN�JOAQUINRECEIVE <br /> nvironmental Health Department <br /> —COU NTY— APR U 9 20i3 PUBLIC RECORDS RELEASE APPLICATION <br /> Oe. Greatness crews her,. <br /> • EWIRON'll B�1 IFjMAIL EHD LOG NUMBER:13$33 <br /> nr�,il�SEi IPE <br /> APPLICANT: Rebecca Natal BUSINESS/AGENCY:Advanced GeoEnvironmental,Inc. <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP:Stockton 1 CA 195242 <br /> PHONE(1): 209-467-1006 PHONE (2):209-623-7200 FAX OR E-MAIL: rnatal@advgeoenv.com <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT „-"J, "'°p o"w DATE 4-9-2018 <br /> 1. List unto ten addresses in the space below. Address ranges WILL NOT be accepted. Select the type(s)of files from the <br /> list below by checking the appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138, mail to the <br /> address indicated below,or email to inforaDsicehd.com. Applications received after 3:00 pm will be processed the next <br /> business day. <br /> 2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted below. <br /> 3. 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 /> 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$152 deposit prior to review. 1'7 <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) ` <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT ( p y 9 p <br /> FILES (Specific addresses only,address ranges will not be accepted) EHD USE ONLY <br /> ❑x Underground Tank(UST) Street# Street Name city <br /> Cleanup Site(LOP) 14"' <br /> ❑CaxsuuEa <br /> • R Other Cleanup Site(Non-LOP) <br /> 1 3001 Navone Rd Stockton <br /> Q Hazardous Waste Nrti <br /> 2908 ❑OA1W <br /> Q Tiered Permitted Facility = Bozzano Rd Stockton <br /> nX Aboveground Tank yU' <br /> RX UST (Monitoring/Removal) T ❑PWS <br /> Q Hazardous Materials 3 2881 Navone Rd Stockton <br /> Q Spill/Release Response WA <br /> u� I I I I l e W aUAD1Y <br /> n <br /> Solid Waste Facility/Vehicle < 3301 Navone Rd Stockton co <br /> Food Facility ytM I <br /> ❑Pool/Spa 5 incnnee <br /> ❑Dairy 6 <br /> Q Land Use Application Sites <br /> R Septic Pumper Truck/ 6 ❑HWSING <br /> Yard/Chemical Toilets <br /> IJ Wastewater Treatment Plant COPA <br /> R Housing Abatement 7 AST I HM I HW <br /> F1 Motel/Hotel <br /> Chicken Rench/Dog Kennel CUPA <br /> Medical Waste Facilely 6 UST <br /> Taftoo/Body Piercing Souo WASTE <br /> Q Waste Tire 9 <br /> Q Complaint <br /> E]Other(Please Specify): ❑Accourmnc <br /> 10 <br /> ***BOXED AREA-EHD USE ONLY*'* <br /> • -q�i -L- `l .. 'tr � ' .tee v �i(ct. r�nf� <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: EHD 46-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 wvvw.sjcehd.com <br />