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1110512010 17:22 Advanced 6eoEnviromental Inc. �V094671118 P.0011001 <br /> ��D � EHD LOG NUMBER <br /> R" Ov ED SAN JOAQUIN COUNTY <br /> N 0 6 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St, Stockton, CA 95202-3029 <br /> Mreg pa-"�-�e el phone: (209)468-3420 Fax: (209)464.0138 Web:www.sjgov.org/ehd <br /> PFS PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Ally Colavita BUSINESSIAGENCY:Advanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITY/STATEIZIP: Stockton, 95215 <br /> PHONE(1): 209-467-1006 PHONE(2): 209-483-3401 FACSIMILE: 209.467-1118 <br /> TENTATIVE*APPOINTMENT DATE: X45 f-(? Time: <br /> m <br /> (Plesae allow I D business days frodata or application submittal--reataeve only-must be confirmed) <br /> ®CHECK BOX TO EXPEDITE REQUEST-$122 FEE(C OR ECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS, <br /> SIGNATURE OF APPLICANT 14-1 — DATE t) <br /> Electronic Information: ❑ List❑Map-Description: <br /> FILE ADDRESS END USE ONLY <br /> Street fi Street Nam* City Unit 1 <br /> 2. o E. ._ t nit2 <br /> 3. r 2 a u f1 ve- <br /> 4• .7 0.Li t vL nit 3 I I�I <br /> 6. q 11 „ <br /> S 3 0 Pa f is Ave, t` �C�Unit4 <br /> 7. <br /> erota <br /> 8. <br /> 10. nit 9 <br /> SpeclNc Date Range of Information Request*d: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ❑X UNDERGROUND TANK(UST)CLEANUP SITE(LOP) Ej HOU6ING ABATEMENT D SOLID WASTE FACILITYNEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY x❑WASTE TIRE <br /> ®UNDERGROUND TANK(MOWORING/REMOVAL) ❑DOG KENNEL ®DAIRY <br /> ®HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ®TIERED PERMITTED FACILITY ❑MOTDLIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ©TATTOOMODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR Review: MONDAY-FRIDAY 8:OO Am-S:00PM(EXCLUDING HOLIDAY$) <br /> 1. List up to ten addresses In the apace above. Select the type(*)of flit@ from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464.0136 or mall to the address indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant If any EHD Was exist. An appointment for review will be confirmed approximately ten (10) <br /> days after receipt of application. The Tues will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that le actively being worked on by EHD staff may not be Immediately available for review. A new application may be <br /> submitted when the filo la available. <br /> 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the expanse of the applicant. <br /> Future file reviews by the same applicant may require a$122 deposit prior to review. <br /> EIID USE ONLY <br /> EHD 40-00 07129110 <br />