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251710:12a Geist Eng& Env Group Inc 5102838644 <br /> P. <br /> r' DECEIVED <br /> DATE RECEIVED B SAN JOAQUIN COUNTY EHD LOG NUMBER JUL 2 5 2011 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue,Stockton, CA 95205-623 <br /> � �TALTI Telephone:(209)468-3420 Fax: (209)464-0138 Web:ww .sj IrL <br /> tPM SIL�ICES PUBLIC RECORDS RELEASE APPLICATI Q W <br /> APPLICANT: e/: t' BUSINESS/AGENCY: <br /> ADDRESS: 20(' ( CITYISTATE/Z1P: (A qymo <br /> PHONE(1): — PHONE(2): ( FAX OR E-MAIL: <br /> Please allow 10 business days from date of application submittal for the records to be lable. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$139 FEE(CASH ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> 1. List up to ten addresses i belo ele a type(s)of files from the list below by checking the appropriate <br /> box(es)- At least one file tyST be selected. Fax to(209)464-0138 or mail to the address indicated above. Address <br /> ranges will not be accepte .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 receipt of application. The files 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. (v/{ <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map— Description: <br /> Specific Date Range of Information Requested: From (q!90 to Z Q j �- <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES EHD USE ONLY <br /> U NDERGROUND TANK(UST) Street# Street Name City <br /> CLEANUP SITE(LOP) ! / ❑CONSUMER <br /> L]OTHER CLEANUP SITE(NON-LOP) ^ <br /> LIA <br /> �HAZAPDous WASTE i I]DAIRY <br /> TIERED PERMITTED FACILITY 2 <br /> ABOVEGRODND TANK � <br /> UST (MONITORING I REMOVAL) I /�C / I _ ❑PWS <br /> HAzARDous MATERIALS <br /> SPILLI RELEASE RESPONSE <br /> WATER.Q11-- <br /> �SOLID WASTE FACILITY I VEHICLE 4 <br /> FOOD FACILITY it 6 C <br /> Fj POOL.SPA C1 SITE MITI DATON <br /> DAIRY 5 <br /> LAND USE APPLICATION SITES <br /> SEPTIC PUMPER TRUCK/ HOUSING <br /> 6 <br /> YARD I CHEMICAL TOILETS <br /> WASTEWATER TREATMENT PLANT UPA <br /> H OUSING ABATEMENT T <br /> MOTELIHOTEL <br /> i <br /> CHICKB�RANCH I DOG KENNEL CUPA-US7 <br /> MEDICAL WASTE FACILITY S <br /> (,�.(TATTDOBODY PIERCING <br /> IYI WASTE TIRE SOLID WASTE <br /> COMPLAINT <br /> OTHER(PLEASE SPECIFY): . <br /> AGCDUNTI N„ <br /> tD I <br /> I <br /> —BOXED AREA EHD USE ONLY— <br /> ,0 1 <br /> �'z D map �N► l'� P d'�: rUir1 <br /> 1 <br /> ❑ Records provided by Staff-PPR Complete. staff Name: <br /> Received Time Jul, 25, 2017 10 : 54AM No. 1958 <br />