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07126/2013 13:58 P.0011002 <br /> EHD LOG NUMBER <br /> DATE RECEIVED SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1 1868 East Hazelton Avenue, Stockton, CA.95205-8232 <br /> T �Q1Zelaphone: (209)468-3420 Fax: (209) 464-0138 Web:www.$)gov.orglehd <br /> PUBLIC RECORDS RELEASE APPLICATION. <br /> cik�:�•.iti. <br /> APPLICANT: Rebecca Natal BUSINEss1AGENCY: Advanced GeoEnvironrnental <br /> ADDRESS: 837 Shkw Road CITYISTATEIZIP: Stockton /CA 195215 <br /> PHONE(1): 209-467-1006 PHONE(2): 209-623-7200 -FACSIMILE: 209-467-1118 <br /> TENTATIVE`APPOINTMENT DATE: AqAP Time: <br /> (Please allow 10 buslnass days from date of applloatlon submittal-"Tentative only-must bo con rrned) <br /> ❑ CHECK BOX To EXPEDITER UST-$125 FEEA UR CHECK Ofill..Y?-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE .21j. iS <br /> IElectronlc information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Dame z <br /> ity Un[t 1 <br /> 1. <br /> 2. nIt 2 <br />'l 3. .(�✓ <br /> 4. Inmix -1 unit 3 <br /> 8. n <br /> � <br /> .7 <br /> i <br /> 6. 1 Unit 4 <br /> 7. <br /> 8. Y ;;L - 0 Unit s <br /> L1110. <br /> 5 tC <br /> '1 i t;. V ��J►� <br /> !:� - Unit 8 <br /> [ o of Information ire uostad: From to <br /> Specific Date Ran � <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> x❑UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSINo ABATEMENT 0 SOLID WASTE FACILITYIVEHICLE <br /> i x[]OTHER CLEANUP SITE(NON-LOP)- []FOOD FACILITY I]WASTETo <br /> x❑UNDERGROUND TANK(MONITOmmeIREMOvAL) ❑DOG KENNEL d DAIRY <br /> x❑HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH' ❑WA$TEWATERTREATMENTPLANT <br /> Q TIERED PERMITTED FACILITY ❑MOTEL KOTEL ❑PUMPER TRUCKIYARDICHEMICALTOILETS <br /> i ❑TATTOo[BoDY PIERCING ❑POOL1315A Q LAND USE APPLICATION SITES <br /> [] MEDICAL WASTE FACILITY i]COMPLAINT RECORDS ❑OTHER(PLEABE$PECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAiLA13LE FOR REVIEW: MONDAY-FRIDAY 8:40 AM-S:00PM(EXCLUDING HOLIDAYS) <br />! 1. LII up, ten addreseeal-in the space above. Select the type(*)of files from the list above by checking:the appropriate <br /> box(es). At least one file typo MUST be selected. Fax to(2021464-9138 or mai[to the addrora`Indicated abova. Address <br /> rangee will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after <br /> 3:80 pm will be processed the next business day. <br />€ 2. The EHD will notify the applicant If any EHD fllee exist. An appointment for review will be confirmed approximately ten(1 D) <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 aot[vely being worked on by EHD.staff may not be Immediately available for review. A new application may be <br /> I submitted when the file Is available. <br /> E 4. Any MG not returned In the same condition as ralaased wlll-be reorganized by EHD staff atthe expense of the applicant. <br /> Future Tile reviews by the same appllcant may require a$125 depoa[t prior to review. <br /> EHE)USE ONLY <br /> I <br /> i <br /> EFID48•a8 � dlllit <br /> Received Time Jul- 26. 2013 1 : 54PM No. 3696 <br />