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I. 0210212015 14:32 ) P.0011001 <br /> ■ <br /> ■ <br /> I ■ - <br /> j■ EHD LOG NUMBER1,rip000 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> FEB 2015 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone, (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> ENVIFI0NMF9iALI-IEA0"1-1, FILE yl <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:_Jennifer Berjikian EIUSINESS/AGENCY:Adyanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Roadk CITYISTATE/ZIP:Stockton, CA 95215 <br /> PHONE(1): 209-467-1006 PHONE:(2).209-483-3401 FACSIMILE: 209-467-1118 <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-"Tantariva only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE -$125 F OR CHECK ONLY)-REQUEST PROCESSED IN 3 US 7DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ LI ap—Description: <br /> f2. FILE ADDRESS EHD USE ONLY <br /> Street 0 Street Name City ❑Unit 1 <br /> 1246 Vanderbilt Circle Manteca <br /> 1299 VanderbiltCurcle Manteca El Unit <br /> 3. 1199 Vanderbilt Circle Manteca <br /> 4. 1153 Vanderbilt Circle Manteca Unita <br /> J <br /> J , <br /> 6. <br /> 6. CfUnit 4 <br /> 7. <br /> 8. C1 Unit fi <br /> 9. 12- 41 <br /> l� <br /> 10- ❑Unit 6 <br /> Specific Data Range of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> x❑UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT Q SOLID WASTE FACILITYNEHICLE Ad <br /> Q OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY Q WASTE TIRE <br /> ®UNDERGROUND TANK(MONrrORING/REMOVAL) ❑DOG KENNEL DAIRY <br /> ❑HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> TIERED PERMrTTED FACILITY ❑MOTEUHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATTOO/BODY PIERCING ❑POOUSPA Q LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY Z COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-S:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses In the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to 1209)484-01,$or all to the address indicated above. Address <br /> ranges will 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 /> 1 The EHD will notify the applicant If any EHD flies exist An appointment for revlew will be confirmed approximately ten(10) <br /> days after receipt of application. The fl lea 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 USE ONLY <br /> EHD 48.00 e11/11 <br /> Received Time Feb, 2, 2015 2: 31PM No. 8008 <br />