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0112212015 16:07 • (F,u) P.0011001 <br /> ttt"� DATE RECEIVED EHD LOG NUMBER <br /> W&--I SAN JOAQUIN COUNTY <br /> CEIVED' ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> JAN 2 3 203elephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> ENVIRONMENTAL HEALTH f L. 0 PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: RebeCCa Natal BUSINESS/AGENCY:AdVanCedQeOEnVjr0n Mental <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP:Stockton /.CA/95215 <br /> PHONE(1): 209-467-1006 PHONE(2):209-623-7200 FACSIMILE: 209-467-1118 <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 busfneas days from date of appllcatlon submittal-'Tonretive only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE RE 3126 FEE 2( " <br /> CHC -REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE �.e.?� ./,4:;7 <br /> Electronic Information: ❑ List❑ Map—Description; <br /> FILE ADDRESS EHD USE ONLY <br /> Straet# Street Name City Unit 1 <br /> 1. Stocktor <br /> z: 19 Miner AvU�l��l�rf> ,��,� &R2 1 <br /> 3' 2150 East Fremont Street Stockton '`��K7 <br /> a• 103 North E Street Stockton Unit3 ✓ t <br /> r <br /> X. 36 D Street Stockton <br /> 6• 124 North E Street kgs Stockton o`UUnit4 <br /> 7- 11 South A Street N\ Stockton <br /> a. 1750 East Channel Street Stockton 0units <br /> s. <br /> 10. 0,Unit 6 <br /> Specific Data Range of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FICES <br /> X❑UNDERGROUND TANK(UST)CLEANUP$ITE(LOP) ❑HOUSING ABATEMENT [AI SOLID WASTE FACILrrYNEHICLE <br /> -1 OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑x WASTETIRE <br /> UNDERGROUND TANK(MONRORINGIREMOVA4 [3 D03 KENNEL [g]DAIRY <br /> Q HAZARDOUS WASTE G ENERATOR []CHICKENRANCH ❑WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑MOTEUHOTEL ❑PUMPER TRUCKIYARDTHEMICA.TOILETS <br /> ❑TATTOO11300Y PIERCING ❑POOLISPA M LAND USEAPPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑X COMPLAINT RECORDS []OTHER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-6:0OPM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses In the space above. Select the types)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to 1208)4(£1-0138 or mall to the address indicated above. Address <br /> ranges will not be accepted-For additional assistance with file addrmes,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 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 some applicant may require a$125 deposit prior to review. J / / <br /> If, ,`JI ( sal Y >f�� i%?�/ L<�_ttlii.i'_.. EtU�SO I'Y`G l2/l 7 f l'� f'u J(/.1 /%Z.o•v / L� �' <br /> 1 t ' iZ"�iiJ1�d 11 d <br /> A -0e `�J 8/1111 <br /> Received Time "Jan. 22. 2015 3:59PM No, 7944 <br />