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DATE RECEIVED EHD LOG NUMBER <br /> y r <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> 'rPUBLIC <br /> APPLICANT: Jennifer Berjikian BUSINESS/AGENCY:Advanced GeoEnviron mental, Inc. <br /> ADDRESS: 837 Shaw road CITY/STATE/ZIP:Stockton/CA/95215 <br /> PHONE(1): 209-467-1006 PHONE (2):209-483-3401 FACSIMILE:209-467-1118 <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 10 June 2015 <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name city — �� ❑ Unit 1 <br /> F1. 1624 Navy Drive Stockton _ <br /> 2. 1621 Navy Drive Stockton 1"r ❑ Unit 2 <br /> 3. 1715 Navy Drive Stockton <br /> 4. O'Unit 3 <br /> 5. SITE MITIGATION <br /> 6. ❑Unit 4 <br /> 7. <br /> g, 9 nit 5 <br /> 9. <br /> 10. ;-CI ❑ Unit s <br /> Specific Date Range of Information Requested: From All to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ❑UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILITYIVEHICLE <br /> ❑OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> ❑UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ❑ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> ❑HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOO/BODY PIERCING ❑COMPLAINTIRESPONSE 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.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted above. <br /> 3. 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 for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <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. 'BOXED AREA-EHD USE ONLY*** <br /> cP RPh t4 0003 ,q 000 6000" <br /> Co _ Oen'VC <br /> "Ckj Cis T2s cfL1066C r C ' <br /> ecor srovided by Staff-Staff-PPR Complete. Staff Name: <br /> EHD 48-06 5111115 <br />