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10 01/20/2015 11:03 (FAX) P.0011001 <br /> I ❑ <br /> I° <br /> 10 DATE RECE �� <br /> ❑ <br /> SAN JOAQUIN COUNTY <br /> EHOLOGNUMBER <br /> ` %\b ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205- <br /> 6232 1� <br /> �p pone: (209)468-3420 Fax: (209)464-6138 Web:www.sjgov.orgfehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Rebecca Natal BUSINESS/AGENCY: Advanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITYISTATE/ZIP: Stockton/CA/95215 <br /> PHONE(1): 209-467-1006 PHONE(2):209-623-7200 FACSIMILE: 209-467-1116 <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Plswso allow 10 business days from date of application submittal-•Tentadvo only-must bo confirmed) <br /> ❑ CHECK BOX TO EXPEDITER E T-5125 FEE{ C CK LY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 1/20/2015 <br /> Electronic Information: ❑ List❑Map— Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street Street Name city Unit 1 <br /> 1. 3808 West Lane Stockton l C� <br /> 2. 4040 West Lane Stockton ffUnit 2 <br /> 3. <br /> 1146 Enterprise Street Stockton <br /> i <br /> 4' 0 Unit 3 <br /> 5. <br /> 6' , /zx� 1 / Lel Unit 4 <br /> 7. <br /> Unit 5 <br /> 9. <br /> 10. <br /> nit 6 <br /> Specific Date Range of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> x❑UNDERGROUND TANK(UST)CLEANUP SITE(LOP) Q HOUSING ABATEMENT I—XI SOLID WASTE FACILITYIVEHICLE <br /> ❑OTHER CLEANUP 6 rrE(N ON•LOP) ❑FOOD FACILITY [E]WASTE TIRE <br /> FAI UNDERGROUND TANK(MONRORING/RalOVAL) ❑DOG KENNEL El DAIRY <br /> 0 HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATERTREATMFM PLANT <br /> Qx TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYARD/CHEMCALTOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOUSPA Q LAND USEAPPLICATION SITES <br /> ❑ MEDICAL WASTE FACIUfY Q COMPLAINT RECORDS ❑OTHER(PLEASE SPECII•Y) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY B:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. list un 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(2091464-0138 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 nett business day. <br /> 2. The EHD will notify the eppllcant N any EHD fil"exlst 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$125 deposit prior to review. <br /> EHD U9E ONLY <br /> ENO A84M will l <br /> Received Time Jan. 20. 2015 10:54AM No- 7929 <br />