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o a IWI aAia3a <br /> l ll8 ' N Wd6 SIOZ 'ZL '9 d 1 P � <br /> EHD LOG NUMBER <br /> 14EMWED SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> FEB 12 2015 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <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: Diane Becker BUSINESS/AGENCY:Advanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP: Stockton <br /> PHONE(1): 800-511-9300 PHONE(2): 714-529-0200 FACSIMILE: 714-529-0203 <br /> TENTATIVE*APPOINTMENT DATE'S Time: <br /> (Please allow 10 business days rolr ate of ap i ation ubmittai-*Tentative only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUE.T $ 5 FEE(C S R ECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 2/9/15 <br /> Electronic Information: ❑List❑Map—Des ription: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name city - Unit 1 <br /> 1, 601 E Kettleman Land Lodi i-W <br /> ►�t"`" '�()u <br /> 2. T ��®[ ' V1 �� Unit 2 '�l <br /> 3. <br /> 4. <br /> El Unit 3 <br /> 5, f <br /> 6. ° <br /> ©Unit 4 <br /> 7. <br /> 8. <br /> ❑unit 5 <br /> 9. °1a <br /> 10. <br /> Q units <br /> Specific Date Range of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> Xj UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT Q SOLID WASTE FACILITYNEHICLE <br /> 0 OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY WASTE TIRE <br /> Q UNDERGROUND TANK(MONITOR(NGIREMOvAL) ❑DOG KENNEL Q DAIRY <br /> El HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> Q TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYARD/CHEMICAL TOILETS <br /> ❑TATTOOBODY PIERCING ❑POOIISPA Q LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY Q COMPLAINT RECORDS ❑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 up 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)464-0138 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 END files 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 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 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 expense of the applicant. <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. <br /> nrvtl�v< co �;Id, c` io..u! S'T °j(4 (g r IeOQ Ln, <br /> EH®48.06 8!1111 t <br />