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■ <br /> 0911712013 17:19 `K) P.0011001 <br /> DA{� EHD LOG NUMBER l <br /> ■■ 1 l' ID SAN .JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> X013 1868 Fast 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: Rebecca Natal BUSINESS/AGENCY: Advanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITYISTATE/ZIP: Stockton /CA/ 95215 <br /> PHONE(1): 09-4671006 PHONE (2): 20.8-623-7200 FACSIMILE: 209-487-1118 <br /> TENTATIVE'APPOINTMENT DATE: ASAP Time: <br /> (Please allow 10 business days from date of appllcatlon submittal-•renfative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE EST $125 FEE(CASH O ECK LY)-R=QUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 1 �')• .� <br /> Electronic Information: [:] Llst E] Map—Description: <br /> F <br /> FILE ADDRESS EHD USE ONLY <br /> Str*at Strout Nam* City rAlunit 1 <br /> 1• 12Q1 Ngrth Qq!jrude Avenue <br /> 2. 1203 North Gertrude Avenue Stockton Unit2 <br /> 3. 1275 North Gertrude Avenue Stocktons <br /> 4. 1448 Shaw Road k an Unit3 <br /> 5. 2 h w <br /> e• 1 1113 Shaw Road Stockton ,Q Unit J <br /> L7- 4343 East Fremont Street Stockton <br /> 8- 4801 Nadottl Road Stockton Units <br /> 9-L <br /> . 1155 North v ( GAj <br /> 10. <br /> L � Units <br /> Specific Date Ranee of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> x❑UNDERGROUND TANK(UST)CLEANUP SITE(LOP) HOUSING ABATEMENTNX <br /> SOLID WASTE FACILITYNEHICLE f(1d dam ( <br /> x❑OTHER CLEANUP SITE(NON-LOP) H FOOD FACILITY WASTETIRE <br /> X❑UNDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL DAIRY <br /> Q HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> x❑TIERED PERMITTED FACILITY MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATTOO/BODY PIERAIN0 POOL/SPA I ]LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑X COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC P9RMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY S:00 AM-6:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addressee In the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(ee). At feast one file type MUST be Selected. Fax to(2091464-0138 or mall to the addroee 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 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 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$125 deposit prior to review. <br /> EHD USF ONLY <br /> EHD 48-06 a V91 <br /> Received Time Sep, 17. 2013 5: 16PM No. 4093 <br />