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CIEIV�D (FAX) P.001/001 <br /> ■NEE �1--RR�-�L�C,�J <br /> AF6 EHD LOG NUMBER <br /> ■ SAN .IOAQUIN COUNTY <br /> JUN U b 2011 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 ,�,/y�A ■tel <br /> ONViRQNly hfTALHrALTH Telephone; (209)468-3420 Fax: (209)464-0138 Web:www,sjgov.org/shd <br /> NEIWItIT15ERiWfCES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Rebecca Natal BUSINESS/AGENCY:Advanced GeoEnvironmental, Inc. <br /> ADDRESS: 837 Shaw Road CITYISTATE/ZIP: Stockton, CA 95215 <br /> PHONE(1): 209-467-1006 PHONE (2):209-623-7200 FAX OR E-MAIL: rnatal®advgeoenv.com <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> ❑ CHECK BOX TO EXPED/I��j RE,,Q^^UE--ST-$139 F SH(aR Cj1E�K ONLY)-REQUEST PROCESSED IN 3 BUS NES DAVE <br /> SIGNATURE OF APPLICANT /Y tI Yl!/ a /'S_I/// DATE <br /> 1. List un to ten addresses in the space ace below.Sele t e type($)of files from the list below by checking this appropriate <br /> box(es). At least one file type MUST be selected. Fax to 12091464-0138 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 business 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 files exist. An appointment for review will be confirmed approximately ten (10) <br /> days after recelpt 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$139 deposit prior to review. (9l� <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-6:00PM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List ❑ Map— Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES EHD USE ONLY <br /> O UNDERGROUND TANK(UST) Stmet# Street Name City <br /> CLEANUP SITE(LOP) 1 510 East Ma I V� ❑CONlUMIII <br /> O OTHER CLEANUP SITE(NON-LOP) <br /> nolia Street Stockton <br /> O HAZARDOUS WASTE ❑DNRY <br /> O TEMD PEAMITfED FACILITY Z 702 North Aurora Street Stockton -fF <br /> O A90VEGROUND TANK <br /> O UST (MCNITORING I REMOVAL) s 1 Lqn U 0PW9 <br /> p HAZARDOUS MATMALS 7 1212 North California Street Stockton <br /> O SPILURELEASE RESPONSE <br /> O SOLID WASTE FACILRY I VEHICLE A WATER QUALITY <br /> 1102 South Aurora Street Stockton N �F• �I I S I� I (/D � <br /> C]FOOD FACILITY <br /> POOL I SPA SITE MInOARON <br /> DAIRY 6 <br /> MX LAND USE APPLICATION 61119 <br /> SEPm PUMPER TRUCK/ NW BIMO <br /> 0 <br /> YARD I CHEMICAL TOILETS <br /> a WASTEWATER TREATMENT PUNT CUPA <br /> F HON91NG ABATEMENT T <br /> MWEUHOTEL <br /> ❑CHICKEN RANCH/DCG KENNEL UPA-UST <br /> MEDICAL WASTE FACILIRv E <br /> ❑TATTOC✓SODY PIERCING calm WAeTE <br /> O WASTE TIRE <br /> I]CONPUINT <br /> ❑OTHER(PLEA9E$PECIPY)I EJACOOUNMNG <br /> 10 <br /> '^9oXED AREA.EHD USE ONLY- <br /> 1 (:, -G-17 ' <br /> Received Ti.me;LJ n., 6._;f) 11t1_3,_45PNrNo. 1631 <br />