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EEmu <br /> varcllcv�io UU.00 (FAX) P.0011001 <br /> 'VATE RER. p � , SAN JOAQvUIN COUNTY EHD LOG NUMBER <br /> H <br /> ass AN 2 12016, 18ENVIRONMENTAL HEALTH DEPARTMENT �� <br /> 88 East Hazelton Avenue, Stockton,on, CCA 95205-6232 <br /> ENV1R0(t 9ENTAL Telephone: (209)468.3420 Fax: (209)464-0138 Web:www.$)gov.org/ehd <br /> HEALTH <br />le PERMITh,FAtnrc& PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Erin Rottacker BUSINESS/AGENCY: Advanced Geo Environmental, Inc. <br /> ADDRESS: 837 Shaw Rd CITY/STATE/ZIP: Stockton, CA 95215 <br /> PHONE(1): 209 467 1006 PHONE(2): FAX OR E-MAIL:erottackerOadvoeoenv.com <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will con ou to arrange an appointment date and time to review the requested records. <br /> ❑ CHECK BOX TO EXP DIT REQUE •$10 EE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 21 June 2016 <br /> 1. List uo to ten addresses In the space below. Se ect the type(s)of flies from the list below by checking the appropriate <br /> box(ee). At least one file type MUST be selected. Fax to(2091464-0138 or mall to the address Indicated above. Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next buslnass day. <br /> 2. For assistance In Identifying the nature and content of EHD records, please contact EHD at the number noted above. <br /> 3. The EHD will notify the applicant If any EHD flies exist. An appointment for review will be confirmed approximately ten (10) <br /> days after receipt of application. The flies will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <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 $130 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS AREAVAILASLE FOR.REVIEW: MONDAY-FRIDAY 5:00 AM•5!00PM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List[] Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS EHD USE ONLY <br /> FILES 61 <br /> UNDERGROUND TANK(UST) Street# Street Name city <br /> CLEANUP SITE(LOP) 17 CCNNUMER <br /> OTHER CLEANUP SITE(NON•LOP) ' 18806 Lower Sacramento Rd Woodbridge <br /> ®HAZARDOUS WASTE p DNPV <br /> ®TIERED PERMITTED FACILITY 2 18970 Lower Sacramento Rd Woodbridge <br /> IEj ASOVEGROUNO TANK <br /> (�UST (MOREMOVAL) <br /> PWS <br /> HA:ADGUSMATERIALS 2 501 D'Arcy Parkway Lathrop <br /> ®SPILLIRELSASE RESPONSE <br /> ❑SOLID WASTE FACILITY 1VEHICLE 4 C3 ATER OINLRY 2 <br /> FOOD FACILITY <br /> F1 POOL/SPA SITE MITIGATION <br /> CQDAIRY 5 <br /> CI LAND USE APPLICATION SITES <br /> HGU6IND <br /> ❑SEPTIC PUMPER TRUCK I ❑ <br /> B <br /> YARD/CHEMICAL TOILETS <br /> ❑WASTEWATER TREATMENT PLANT MtUPA <br /> ❑HOUSING ABATEMENT 7 <br /> ❑MomjHe ID <br /> CHIOKEN RANCH/DOG KENNEL COPA•HA2•MAT <br /> El <br /> a <br /> ❑MEDICAL WASTE FACILITY <br /> ❑TATTOO/aODY PIERCING 13 SOLID WAI TE <br /> ❑WASTE TIRE B <br /> CGNPVJM <br /> ❑OTHEH(PLEASE SPECIFY): ACCOUNTINO <br /> 10 <br /> —BOXED AREA-EHD USE ONLY- <br /> 1�ifvtue Ju ous'6_�9:39A�IVoi 0906. Name: <br />