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0513112012 10 :08 Advanced GeoErww9mentalInc , fFAW09 467 1118 P .0011001 <br /> ATE RECEIVED SAN JOAQUIN COUNTY LHI) LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> L� 600 East Main St. Stockton , CA 952023029 ` <br /> Telephone, (209) 4883420 F= (209) 464-0138 Web: www.sjgov.org/ehd a <br /> 11UIFUFIl h51Af_ "UA -�lU <br /> ®t,��l,ntTrst�dt�E PUBLIC RECORDS RELEASL APPLICATION <br /> APPLICANT: Ally Cotavlta BUSINESS/AGENCY: Advanced QeoEnvlronmental <br /> ADDRESS: 837 Shaw Road CITY/STATEIZIP : Stockton I CA 196215 <br /> PHONE (1): 209=4674006 PHONE (2): 209483.3401 FAC8IMILE: 209467-1118 <br /> TENTATIVE" APPOINTMENT DATE: ASAP ITime: <br /> (Please allow 10 buslnesa days from date or application submittal - •TentatMe only - must be confirmed) <br /> ® CHECK BOX TO EXPEDITE REQU 25 FEE OR HEC NLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 06/31112 <br /> Electron lc informations ❑ List ® Map e Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street 9 Street Name city El Unit 1 <br /> 1 . 841 West Bianchi Rd �( a Stockton <br /> 2. 4415 Pacific Ave Stockton 'El Unit 2 , <br /> 3. 4405 Pacific Ave Stockton ((k <br /> 4. jUnlf 9 <br /> 5. "Do not need LUST file* (Unit 4) for the ;o'�lZe- 5C&A&e mise <br /> �. Sbs...only active UST Info (a.g., Grv^/ ,p Unit <br /> 7. Inspections, teating, ate.) <br /> k8• > uRS <br /> i <br /> 9. <br /> 10. <br /> • ilntt s <br /> Specific Data Range of Information Raquestad: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ❑ UNDERGROUND TANK (UST) CLEANUP SITE (LOP)-r(JU". ® HOUSING ABATEMENT ® •SOLID WASTE FACILITYNEHICLE <br /> ® OTHER CLEANUP SITE (NON-LOP) ® FOOD FACILITY ® WABTETIRE <br /> ® UNDERGROUND TANK (MONITORINGIREMOVAL) ® DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ® WASTEWATER TREATMENT PLANT <br /> ® TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑ TATTOOISODY PIERCING ® POOLiSPA ❑ LAND USE APPLICATION 81TES <br /> ® MEDICAL WASTE. FACILITY ® COMPLAINT RECORDS ❑ OTHER (PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILA®LE FOR REVIEW: MONDAY-FRIDAY 8 :00 AM4:00PM (EXCLUDING HOLIDAYS) <br /> 1 . List up to ton addressee In the space above. Select the type(s) of flies from the Hat above by checking the appropriate <br /> box(es). At least one file type MUST he selected. Fax to (209) 454-0188 or mail to the address Indlcaked above. Address <br /> ranges will not be accepted • for additional amalstance with fie 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 Elln files exist, An appointment for review will be confirmed approximately ten (10) <br /> days attar receipt of application. The flies will be held 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 available for review. A now application may be <br /> submitted when the file In 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 $126 deposit prior to review. <br /> EHD USE ONLY <br /> MHD PoEA@ <br />