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I 11118/2014 16:38 TAX) P.0011001 <br /> I <br /> I� QA .)�ECEIVED EHD LOG NUMBER <br /> I� �� ;_ ?� z"` SAN JOAQUIN COUNTY <br /> ��� G'Y."��' `"'" ENVIRONMENTAL HEALTH DEPARTMENT /} <br /> NO 1868 East Hazelton Avenue, Stockton, CA 95205-6232 {/ <br /> h�V 1 ZEi' Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> ENVIRONMENTAL HEALTkI <br /> PERMIT/SERviCES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:Jennifer Beriikian BUSINESS/AGENCY:Advanced GeoEnvironmental <br /> ADDRESS: 837 North Shaw Road CITY/STATEOP: Stockton, CA <br /> PHONE (1): (209)467-1006 PHONE(2):(209)483-3401 FACSIMILE: (209)467-1118 <br /> TENTATIVE"APPOINTMENT DATE: ASAP Time: <br /> (Please allow 10 business days from date of appllcatlon submttel-'Tentative only-must be confirmed) <br /> ❑CHECK BOX TO E(PEDffE R Q $�FEH OR CHECK ONLY)-REQUEST PROCESSED IN B SJNESS DAYS <br /> SIGNATURE OF APPLiCA DATE (d <br /> Electronic information: ❑ 'st a iption: <br /> FILE ADDRESS EHD USE ONLY <br /> Street 0 Street Name city UnR 1 <br /> �. 230 East Fremont Street Stockton <br /> 2. 401 North San Joaquin Street Stockton M-Unite I <br /> 3. <br /> 4• nit 3 <br /> 5. <br /> 8• 4,mZ/ �•-- nit4 <br /> 7. <br /> 8. Unit B <br /> 9. <br /> 10. nit 9 <br /> Specific Data Flange of Information Requested: From _ all _ to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> x❑UNDERGROUND TANK(UST)CLEANUP SiTE(LOP) ❑HOUSING ASATEWNr Q SOLID WASTE FAGLRYNEHiCLE <br /> ❑x OTHER CLEANUP SiTE(NON-LOP) ❑FOOD FACILIiY O WASTETIRE <br /> D UNDERGROUND TANK(MONITORING1R9=AL) ❑DOG KENNEL DAIRY <br /> ❑x HAZARDOUS WASTE G ENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑x TIMM PERMITTED FACILITY ❑MOTWHOTEL ❑PLWER TRUCKIYARD/CHERCALTOILUS <br /> ❑TATroofmV PIERCING ❑POOUSPA Q LAND USE APpurAmm SITES <br /> ❑ MEDICAL WASTE FAaLr[Y Fxl COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND S9PTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List un to ten addresses in the space above. Select the type(s)of flies from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(2091464-0136 or mail to the address Indicated absna_ Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Application received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant If any EHD flies 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 revlew. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that Is actively being worked on by EHD staff may not be Immediately available for review. A new application may be <br /> submitted when the file is available. <br /> 4. Any fila 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$126 deposit prior to review. <br /> EMD USE ONLY <br /> i <br /> Received eTie Nov. 18. 2014 4: 20PM No, 7590 8!1171 <br />