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v1r1tircv1y VU.vi (I Ax) P.001I001 <br /> ■ ■ <br /> ■ <br /> ■ ■ <br /> ■ <br /> ■ � �' SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> JAN 1 2 14. 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone; (209)468-3420 Fax: (209) 464-0138 Web: www.sjgcv.org/ehd <br /> 0-4VIRON'f�,ABi TAL HEALCi- <br /> PEHI+f IT/S EW C IL- <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Rebecca Natal BUSINESSIAGENCY: Advanced GeoEnvlronmental <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP: Stockton /CA /95215 <br /> PHONE (1): 209-467-1006 PHONE(2): 2,0-623-7200 FACSIMILE: 209-467-1118 <br /> TENTATIVE*APPOINTMENT DATE: ASAP Time: <br /> (Please allow 10 business days from date of appllcatlon submittal-'Tentative only-must be conrflm,ed) <br /> ❑ CHECK 60X TO EXPEDITE REQUEST-$123 FEEH CFC ONLY)-REQUEST PROCESSED IN 313USINESS DAYS <br /> SIGNATURE OF APPLICANT <br /> n• f <br /> DATE I I L <br /> Electronic Information: ❑ List❑ Map— Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Stroet# Stmt Nemo Clty <br /> 1 12431 Mari osa Road Stockton /1- `�( l <br /> 2• 2467 Mariposa Road Stockton `unit <br /> 3• 2501 S. Route 99 W. Fronto e Rd; Stockton J ! f <br /> a 2459 Mariposa Road StocktonED Unit3 <br /> g 2373 Mariposa Road ✓ Stockton icr 'j <br /> 5 2701 South Highway 99 Stockton G <br /> 8 unit a <br /> 7- 2327 Mariposa Road ✓ / Stockton PC;f ' <br /> B. 2447 Mariposa Road Stockton nits <br /> 8. <br /> 10. <br /> ,D Unit 8 <br /> Speclflc Date Range of information Requested: From all to ` <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ❑x UNDERGROUND TANK(UST)CLEANUP SITE(LOP) []HOUSING ABATEMENT ❑SOLID WASTE FACILITYNEHICLE AtO L—_) <br /> x❑OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY Q WASTE TIRE <br /> ❑x UNDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL Q DAIRY <br /> x0 HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> x❑TIERED PERMTTED FACILITY ❑M OTEUH OTEL ❑PUMPER TRUCK/YARWC HEMICAL TOILETS <br /> ❑TATTOO160DY PIERCING ❑POOUSPA Q LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY 0 COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-6:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten oddresses In the space above. Select the type(5)of files from the flat above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mall to the addrej25 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 files exist. An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The files wl11 behold for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3, A file that Is actively being worked on by EHD staff may not be Immediately avallabie for review. A new application may be <br /> submitted when the file is available. <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$125 deposit prior to review. <br /> FHO USE ONLY <br /> EHD 4A-0A <br /> e/1111 <br /> ,eived Time Jan, 14. 2014 9:01AM No, 4997 <br />