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® 10124/2014 08:22 (FAX) P.0011001 <br /> ■ <br /> I ■ <br /> ■ <br /> DATE RECEIVED EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT �x <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> 4 Telephone, (209)468-3420 Fax: (209)464-0138 Web: www.sj'gov.org/a <br /> F I <br /> IE `V <br /> PERWT(SE"Vlo Es PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:Jennifer Bedikian SUSINESSIAGENCY:Advanced GeoEnviron mental <br /> ADDRESS: 837 North Shaw Road CITY/STATEIZIP: Stockton, CA <br /> PHONE(1): (209)467-1006 PHONE(2):(209)483-3401 FACSIMILE: (209)467-1118 <br /> TENTATIVE'APPOINTMENT DATE: ASAP Time: <br /> (Please allow 10 business days from date of application submfttal-"Tontsfive only-mu3t be co nne ) <br /> [] CHECK BOX TO EXPEDITE QU OR CHECK ONLY)-REQUEST PROCESSED IN tUj!!7j4 <br /> SIGNATURE OF APPLIC $125 FEE DATE <br /> Electronic Information: Map—Description: <br /> FILE ADDRESS \,a4��EHDUSE ONLY <br /> Street# Street Name City fV -0 Unit 1 <br /> 1. 3400 Newton Road Stockton — <br /> I <br /> 2. 3516 Newton Road i( Stockton 'L I Unit <br /> 3. 3535 Cherokee Road Stockton <br /> 4. 3655 East Cherokee Road Stockton I I C-C� � unft3IV; <br /> 6• E Unft4 <br /> 7. <br /> 80 Unit 5 <br /> 10. C' / 0 Unit 6 <br /> Specific Date Range of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> x0 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITYNEHICLE 1� <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY Q WASTE TIRE <br /> Q UNDERGROUND TANK(MONrrORINGIREMOVAL) ❑DOG KENNEL Q DAIRY <br /> x❑HAZARDOUS WASTE G ENERATOR ❑CHICKEN RANCH ❑WASTEVVATERTREATMENr PLAVIF <br /> Q TIERED PERMITTED FACILITY ❑MOTEUHOTEL ❑PUMPERTRUCK/YARDICHEMICALTOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOUSPA Q LAND USE APPLICATION SrrES <br /> I] MEDICAL WASTE FACILITYx❑COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up 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. Foto(2091464-4138 or mall to the address indicated above. Address <br /> ranges will not be aocapted-for additional nazintnnce with Flle 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 file Is available. <br /> 4. Any file not retumed 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$126 deposit prior to review. <br /> END USE ONLY <br /> EHD 4" wilil <br /> Received Time Oct. 24. 2014 8:04AM No. 7401 <br />