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1012812015 09:02 —' ) P.0011001 <br /> r ��� ,J�� ENp LOO NUMBER <br /> ISN R/ SAN JOAQUiN COUNTY <br /> OCT 28 ZoiS ENVIRONMENTAL HEALTH DEPARTMENT Q <br /> AOV <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 U <br /> ENVIRONMENTAL HEAL79 <br /> "'phone: (209)468.3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Jennifer Berjiklan BUSINESS/AGENCY.Advanced GeoEnvironmentai <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP:Stockton,CA 95215 <br /> PHONE(1): 209467-1006 P14ONE(2); 209483-3461 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 REQUE CASH OR CHECK ONLY)-REQUEST PROCESSED IN nNWS UAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑List Map-Description: <br /> FILE ADDRESS <br /> EHD USS ONLY <br /> Street# 'Street Name City <br /> 825 Navy Divey f� Stockton <br /> 2. 1137 South Stockton Street q--?L10/A6f Stockton Unit <br /> 240 Navy Drive uf] O/I i�t Stockton - F u L{Q'� ❑Unit 2 <br /> 1145 West Charter Way yZ (t Stockton �� U Unit 2H t <br /> ter, 939 West Charter Way Stockton <br /> 8. nit 3 <br /> 7. nit4 <br /> 8. `� �re.� MGATION <br /> 70. r ` ' nit ti <br /> Spoclflc tato Rengo of Information Requested: From to <br /> ENVIRONMEN s i LTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SiTE(LOP) MED .WASTE FACILITY LiD WASTE FACiLrrYNEHICLE <br /> THER CLEANUP SITE oN-LOP ❑ N4 AHATENIENT [WASTE TIRE <br /> (N ) <br /> RUNDERGROuND TANK(MONtTORINOIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> �YEGROUND TANK ❑CHICKEN RANCH/OoG KENNEL ❑WASTEWATERTREATUENT PLANT <br /> AZARDOUS WASTEiMAZARDOUS MATERIALS ❑MOTEL/HOTEL ❑.PUMPER TRUCK/YARDICHEMICAL TOILETS <br /> ❑TiERED PERF TTED FACILITY ❑P <br /> ArOLISVA ❑LAND U61:APPLDCAT{ON SITES <br /> ❑TATToo/BODY PIERCING ComPLAiNT/RESPONSE RECORDS Q OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOUDAYS) <br /> 1. Ust 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 12091484-0138 or mall to the address Indicated above, Address <br /> ranges will not be accepted.Applications received after 9:00 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 Riles exist. An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The flies will be hold 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 exponsa of tho applicant. <br /> Future file reviews by the same applicant may require a$130 deposit prior to review. .-`ROXEU AtfA-EHD USE ONLY"' <br /> i, <br /> p Records provided by Staff-PPR Complete.staff Name: <br /> END 4D•06 7+1196 <br /> Received Time Oct. 28. 2015 8.54AM No 9891 <br />