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Jan . 26 , j22010 1024AM Ad fed Geo Environmental No , 6332 P . 1 / 1 <br /> IRROWEQSAN JOAQUIN COUNTY EHD LOG NUMBER <br /> JAN 2 b 2010 ENVIRONMENTAL HEALTH DEPARTMENT <br /> t� <br /> 600 East Main St. Stockton , CA 95202-3029 Lo <br /> ENVIRONMENT HEALTNaphone : (209) 468-3420 Fax: (209) 464-0138 Web : www.sjgov.org/e d <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: ARTHUR DEIME BUSINESS/AGENCY: AnvnNCED GEOENVTRONMENTliL , INC <br /> ADDRESS : 837 SHAW ROAD_ _ CITYISTATEMP: STOCKTON, CA 95215 <br /> PHONE (1 ) : 209 "467 - 1006 PHONE (2): 209 - 323 - 6497 FACSIMILE: 209 - 467 - 1118 <br /> rENYArIVE" APPOINTMENT DATE Time: <br /> (Please allow 70 business days from data or application submittal • "TentaUve only • meat be confirmed) <br /> © CHECK BOX YO EXPEDITE REQUEST - $115 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 25 JANUARY 2010 <br /> Electronic information : ❑ List ❑ Map — Description : <br /> FILE ADDRESS EHD USE ONLY <br /> Street $treat Nama City <br /> 1 . 6230 PACIFSC AVENUE STOCKTON <br /> 20 _-. ... ❑ Unit2 <br /> 4. <br /> ... _ . . .._ ..... ... nit3 <br /> 5. <br /> 6, nl <br /> 7. <br /> 8' (] Units <br /> 91 <br /> El unit 0 <br /> low <br /> Specific Date Range of Information Requested: From 1991 to 2009 <br /> f�I ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> LJ UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACIUTYNEHICLE <br /> ❑ OTHER CLEANUP SITE (NOWLOP) F1 FOOD FACILITY F ❑ WASTETIRE <br /> VNDERGROUNB TANK (MONITORING/REMOvAL) ❑ DOG KENNEL ❑ DAIRY <br /> )❑jx HAZARDOUS WASTE GENERATOR E] CHICKEN RANCH ❑ WASTEWATERTREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELMOTEL ❑ PUMPERTRUCKIYAROICHEMICALTOILETS <br /> ❑ TATTOOIBODY PIERCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER (PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5 :00PM (EXCLUDING HOLIDAYS) <br /> 1 . List un to ten addresses in the space above. Select the type(s) of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to (209) 464.0136 or mail to the address 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 will be held fora maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that is actively being worked on by END staff may not be Immediately available 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 expollse Of the applicant. <br /> Future file reviews by the same applicant may require a $115 deposit prier to review. <br /> 5. If you need further assistance, please contact Diane Martinez, at (209) 468-3425. <br /> ENo USE ONLY <br /> EHn 4806 8127109 <br />