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1212412014 10:29 <br />DATE RECEIVED <br />■ <br />RECD DEC 2 4 2014 <br />61 <br />Telepho <br />(I -AA) <br />F.UU I IUU I <br />EHD LOG NUMBER <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 79l'155 <br />(209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov,org/ehd <br />PQBLIC RECORDS RELEASE APPLICATION <br />APPLICANT:Jennifer Berji <br />ADDRESS: 837 North Sh <br />PHONE (1): (209)467-1006 <br />TENTATIVE+ APPOIh <br />(Please allow 10 t <br />® CHECK BOX TO EXPEDn <br />SIGNATURE OF APPLICAN <br />n <br />Road <br />(NESS/AGENCY: Advanced GeoEnvironmental <br />CITY/STATE/ZIP: Stockton, CA <br />PHONE (2):(209)483-3401 <br />FACSIMILE. (209)467-1118 <br />MENT DATE: ASAP _ Time: <br />slneae days from date of application submittal -'Tentative only -must be confirmed) <br />REQUESTj4t2' EE SH OR CHECK ONLY) . REQUEST PROCESSED IN 3 BUSINESS DAYS <br />DATE bq 110 ILI <br />Electronic Information: Q Ist Map - Description: <br />F LE ADDRESS <br />EHD USE ONLY <br />. Unit 1 <br />Street d <br />Street Name <br />City <br />9. <br />11101 <br />E ST R 4 HWY <br />Stockton <br />tjo PIZ• A d El Unit <br />2, <br />603 <br />Best R ad <br />Stockton <br />3. <br />11030 <br />Copps opolis Road <br />Stockton <br />cec 6c-( �t I <br />b C-0 No P2 <br />4.South <br />A ck Tone Road <br />6. <br />10333 <br />E ST R 4 HWY <br />-Stockton,-, <br />Stockton - <br />S' <br />;,-GC - [ 'Unit <br />S. <br />11555 <br />E,.ST RT 4 HWY <br />Stockton <br />7. <br />L,AJ <br />0 units <br />8. <br />9. <br />-Unit e <br />10. <br />Specific Dote Range of Information R qusatod: From all to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />x® UNDERGROUND TANK (UST) CLEANUP SITE (LOP) E HOUSING ABATEMENT ®x SOLID WASTE FACILITYNEWICLE <br />OTHER CLEANUP SITE (NON -LOP) ® FOOD FACILITY WASTE TIRE <br />x® UNDERGROUND TANK (MONFORINGIR MOVAL) ® DOG KENNEL DAIRY <br />F1 HAZARDOUS WASTE GENERATOR ® CHICKEN RANCH ❑ WASTEWATER TREATMENT PLANT <br />TIERED PERMITTED FACILITY ❑ MOTEL/HOTEL PUMPER TRUCKIYARDICHEMICAL TOILETS <br />TATTOOII30DY PIERCING ® POOL/SPA LAND USE APPLICATION SITES <br />® MEDICAL WASTE FACILITY ® COMPLAIN' RECORDS ® OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT REGoliDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 5:00 AM-5:00PM (EXCLUDING HOLIDAYS) <br />1. Llat up to ten addresees In the space above. Select the type(a) of files from the list 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 address Indicated above. Address <br />ranges will not be accepted - f r additional assistance with file addresses, contactthe EHD. Applications received after <br />3:00 pm will be processed the next business day. <br />2. The EHD will notify the appllc nt If any EHD files exist. An appointment for review will be confirmed approximately ten (10) <br />days after receipt of applicatio i. The files will be held for a maximum of rive business days for review. Appointments <br />should bs scheduled accordin Ily. <br />3. A file that Is actively being woi ked on by EHD staff may not be Immediately available for review. A new appllcation may be <br />submitted when the file Its aval able. <br />4. Any file not returned In the sar�e condition as released will be reorganized by EHD staff at the expense of the applicant. <br />Future file reviews by the sem applicant may require a $125 deposit prior to review. <br />(roar-.. 'r •r-0'. l erorxi' W j <br />ecei_v_ed Time—Dec, 24.-2014-10:22AM—No, 7781 <br />