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1302 11/0512015 15:57 (FAX) P.0011002 <br /> 12 <br /> 9 1EDATE RECEIVED p EHD LOG NUMBER <br /> 5MM REGI I CSD SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPAR �I®(A <br /> NOV 0 6 2095 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Y' <br /> 11 <br /> ENVIRONMENTAL HEALTHTelephone: (209)468-3420 Fax: (209)464-0138 Web:www,sjgov.org/ehd <br /> PERMITISERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Jennifer Bed kian BUSLNESS/AGENCY:Advanced GeoEnviron mental <br /> ADDRESS: 3335 E. Miraloma Ave Suite 142 CITY/STATE/ZIP: Anaheim, CA 92806 <br /> PHONE (1): 714-529-0200 PHONE (2): FACSIMILE:-209-467-1118 <br /> Please allow 10 business days from date of application submittal forthe records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records, <br /> HECK BOX TO EXPEDITE Q -913 E(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIG ATL <br /> OF APPLICANT a DATE (L <br /> Electronic Information: ❑ List Map-Description: <br /> FILE ADDRESS <br /> street M Street Name City EHD USE ONLY <br /> +• 4020 Newton Road Stockton <br /> 2. El <br /> Unit 1 <br /> El 3. <br /> Unit Y <br /> 4. <br /> Unit 2H <br /> 5. <br /> 7. --// Imo ' <br /> D-Unit4 7 <br /> 8' TE MITIGATION <br /> 9. <br /> 10, � <br /> nit S <br /> Specht Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SrrE(LOP) ❑MEDICAL WASTE FACILITY k]c SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT OWASTE TIRE <br /> [X]y'UNDERGROUND TANK(MONITORINWREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> [2 <br /> [ ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> (ZHAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTEUHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOLISPA ❑LANG USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING ]COMPLAINT/RESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PERMITRECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses In the space above. Select the typa(s)of files from the Ii5t above by checking the appropriate <br /> box(es). 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 business day. <br /> 2. For assistance In Identifying the nature and content of END records,please contact EMD 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$130 deposit prior to review. "'BOXED AREA-EHD USE ONLY' <br /> ❑ Records provided by Staff-PPR Complete. staff Name: <br /> EHD 40-0e _ 7Hn6 <br /> Received Time Nov. 5, 2015 3:49PM 0. 9958 <br />