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■ <br /> 0810212012 16:34 Advanced GeoEr ''omental Inc. irV)209 4671118 P.0011001 <br /> SATE RECEIVED tr'IU LUC9 IVUIVICtI( i <br /> `■ � �",�1 SAN ..IOAQUIN COUNTY <br /> C■ rit ������� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> t4ephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> 6MVI ONNIt•;1 AL HEALT3H FILE CO <br /> PEHMITJSEP]1C,ES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Robert Marty gUSINESS/AGENcY: Advanced Geo,Environmental <br /> ADDRESS: 837 Shaw Road CITY/STATEIZIP: Stockton / CA /95215 <br /> PHONE(1): 209-467-1006 PHONE(2): 209-969-3239 FAC81MIL.E: 209-467-1116 <br /> TENTATIVE*APPOINTMENT DATE:_ASAP Time: <br /> (Please allow 10 business days from date of application submittal-'Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST- 5 FE R CHECK ON REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE q'0;21 X:2 — <br /> Electronic Information: ❑ List❑ Map–Descriptlon: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City unit 1 <br /> 1• <br /> 1023 E VINE ST LODI <br /> 2. $20 S CLUFF AVE LODI p,UnIt2 <br /> 3• 1025 INDUSTRIAL WAY LODIi <br /> 4. <br /> Ej Unit 3 9 �1 <br /> 6. <br /> 6• unit a.l <br /> 7. Ej' <br /> 8. <br /> Unit 6 <br /> 9. ' <br /> X1251(Z . <br /> Onit e <br /> Specific Date Range of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> x❑UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT SOLID WASTE FACILITYNEHICLE /VDJ <br /> Q OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITYx❑WASTE TIRE <br /> ❑X UNDERGROUND TANK(MONITORINOIREMOVAL) ❑Doo KENNELx❑DAIRY <br /> ❑x HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> X❑TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYARD/CHEMICAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOLISPA Q LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY 0 COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-$:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List un to ten addrosses In the space 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. F-A&AQ 12091464-0138 or mall to the address Indlcatod above. Addreas <br /> rangss:,wlll not be accepted -for additional assistance with file addressee,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 filo Is available. <br /> 4. Any filo not returned In the sumo condition as released will be reorganized by EHD staff at the expense of the applicant. <br /> Future filo reviews by the same applicant may require a$126 deposit prior to review. <br /> EHD USE ONLY <br /> °Received Time Aug. 2. 2012 4: 31PM No, 0721 '" <br />