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I© 10113/2014 17:01 (FAX) P.0011001 <br /> Ia <br /> I ® <br /> j® EHD LOG NUMBER <br /> ® DA- RE <br /> t _ SAN JOAQUIN COUNTY <br /> . - <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1 B68 East Hazelton Avenue, Stockton, CA 95205-6232 F✓' <br /> 00 I 3 2014 Telephone: (209)468-3420 Fax: (209) 464-0138 Web, www.sjgov.org/eh'd <br /> ENVIfiONNIEWCALHEA <br /> PERMITISEIIVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT-.—Rebecca Natal BUSINESS/AGENCY: Advanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITY/STATEIZIP: Stockton / CA /95215 <br /> PHONE (1): 209-487-1006 PHONE (2): 209-023-7200 FACSIMILE: 209-467-1118 <br /> TENTATIVE*APPOINTMENT DATE: ASAP Time: <br /> (Please allow 10 business days from date of applica on submittal-"7'entative only-must be con nn <br /> ❑ CHECK BOX TO EXPEDITE RE .$125 FEE( 0 C C Y)-REQUEST PROCESSED IN 3 BUS] SS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List❑ Map—Descrlptl n: <br /> FILE ADDRESS EHD USE ONLY <br /> F2. Street 0 Street Name City nit 1 <br /> 740 North Cluff Ave Lodi <br /> 802 North Cluff Ave Lodi 7 /;, Z Unite3- 1333 Ea Turner Rd Lodi <br /> 4. �� c �� �' yet y 3 , nit 3 <br /> 5. r L -7 <br /> 6' ' M'Un I 4 jo 21 <br /> 7. <br /> 8, LYSEl Unit 6 <br /> 10. <br /> OaR71Z� <br /> i UnIt 6 <br /> Specific Date Ranee of Information Requested: From all _ to / <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> x1 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑x SOLID WASTE FACILITYNEHICLE <br /> X1 OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY Q WASTE TIRE <br /> O UNDERGROUND TANK(MONITORING/RDMVAL) ❑DOG KENNEL DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑CHCKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY ❑MOTEIIHOTEL ❑PUNVERTRUCKNARD/CHEMICALTOILETS <br /> ❑TATTODIBODY PIERCING ❑POOUSPAx❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY [fl COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List uA-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)464-0138 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 next buslness day. <br /> 2. The EHD will notify the applicant If any EHD tilos exist. An appointment for review will be confirmed approximately ten(10) <br /> days akar recelpt of application. The files will be hold for a maximum of five bu2iness 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 lmmed12tely 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 same applicant may require a$125 deposit prior to review. <br /> EHD USE ONLY <br /> EHD 4" <br /> Received Time Oct. 13, 2014 4:45PM No, 1321 <br />