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�M 09/1712013 17:19 ) P.001/001 <br /> �1 / "- EHD LOG NUMBER <br /> M f � a <br /> fill DA art SAN JOAQUIN COUNTY <br /> RM <br /> Qf ENVIRONMENTAL HEALTH DEPARTMENT - <br /> -3EP 18 2013 1868 East Hazelton Avenue, Stockton, CA 95205-6232 J <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Rebecca Natal BUSINESSIAGENCY: Advanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP: Stockton / CA / 95215 <br /> PHONE (1): 209-467-1008 PHONE (2): 209-623-7200 FACSIMILE: 209-467-1118 <br /> TENTATIVE'APPOINTMENT DATE: Aggp Time: <br /> (Please allow 10 business days from data of application submittal-'renfeflve only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE EST $125 FEE(CASH O ECK LY)-R QUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE ' /7- 1 t3 <br /> Electronic Information: ❑List❑ Map–Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Straet M Street Name city <br /> 1• 1201 North GpirtrudeAvenue <br /> 2• 1203 North Gertrude Avenue Stockton 71runit2 '1 <br /> 3. <br /> 3• 1275 North Gertrude Avenue Stocktons <br /> 4• 1448 Shaw Road Y\ff StopKtQn Unit3 <br /> 6. 1282 Shaw 1 jAd K- <br /> e• 1113 Shaw Road -6-) Stockton Erle BlDd J `UnIt4 V/U <br /> 7- 4343 East Fremont Street d2 Stockton <br /> 2p5lcj $/lam Lair/ <br /> s- 4801 Nadottl Road "fF Stockton 0 Units <br /> 9- 1155 North Gertrude Ave�ueti Stockton <br /> 10. 1 1 1 2TIGnIt e <br /> Specific Data Ranee of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> x❑UNDERGROUNDTANK(UST)CLEANUP SITE(LOP) HOUSING A9ATEMENTX SOLID WASTE FACILIYNEHICLE <br /> ElOTHER CLEANUP SITE(NON•LOP) E FOOD FACILITY X WASTETIRE <br /> Q UNDERGROUND TANK(MONITORINOIREMOVAL) ❑DOG KENNEL DAIRY <br /> x❑HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> D TIERED PERMITTED FACILITY MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATTOO/13ODY PIERCING POOUSPA ®LAND USE APPLICATION$ITEO <br /> ❑ MEDICAL WASTE FACILITY ❑X COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SBPTIC PORMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 6:00 AM-6:00PM(EXCLUDING HOLIDAYS) <br /> C List up to ten addresses In the apace above. Select the type(s)of files from the list above by checking the appropriate <br /> box(ee). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address Indicated above. Address <br /> ranges will not be accoptad-for additional assistance with file addresses,contact the EHD. Appilcationa 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 revlaw will be confirmed approximately ten(10) <br /> days after receipt of application. The filers will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A fife 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 to 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 /> EHD IB-08 07—1 <br /> Received Time Sep, 17, 2013 5 : 16PM No. 4093 <br />