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0412 512014 17:41 • AX) P-90*01 <br /> ■ DATE IZEC :"� •,•_,,:EHp;LOG NU[4tBEf7.... <br /> rr RECSAN .IOAQUIN COUNTY y <br /> ENVIRONMENTAL HEALTH DEPARTMENT : `I <br /> APR 2.� 2014 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Teleph ne: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd � <br /> ENVIRONMENTAL HE&"M <br /> PERMITISERVICES UBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Rebecca atal BUSINESS/AGENCY: Advanced GeoEnvironmental <br /> ADDRESS: 837 Shaw oad CITY/STATE/ZIP: Stockton /CA/95215 <br /> PHONE(1): - PHONE(2):_209-623-7200 FACSIMILE. 209-467-1118 <br /> TENTATIVE`APP iNTMENT DATE: AOAp Time: <br /> (Please allow 0 business days from date of application submittal-*Tentative only-must be conflmled) <br /> ❑CHECK BOX TO EXP DITE REQ ES' -$125 FEE(CA CK 0 UEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF ApPLIC NT DATE <br /> Electronic Information; List❑ Map—Descrlptlo <br /> FILE ADDRESS EHD USE ONLY <br /> Street t! Street Name City p U it 1 <br /> 1. 300 We t Pine Street Lodi t3ob cc Sp <br /> 2. 12 Chu ch Street Lodi n,P t,Cs�s f2 ffUnit2 <br /> 230 Elm Street Lodis'.u' <br /> 124 Elm Street Lodi W"3 gmt"'PIISr ro�`" Unit3 <br /> 5. 107 School Street Lodl usr ;�cca�P <br /> Unit 4 <br /> L7. Unit 6 <br /> 0`Unit 6 <br /> Speclflc DatD Range of lnformad n Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> QUNDERGROUND TANK(UST)CL NUPSITE(LOP) ❑HOUSING ASATEfutFME❑SOLID WASTE FACILITYNEHICLE p)e? <br /> E❑OTHER CLEANUP SITE(NON-LOP ❑FOOD FACILITY Q WASTE TIRE -1 &D � <br /> UNDERGROUND TANK(MONirORi EM <br /> ROVAL) ❑DOG KENNEL O DAIRY 1 1.00, <br /> , <br /> ❑x HAZARDOUS WASTE GENERATOR ❑CFpCKEN RANCH ❑WASTEWATERTREATMENiPLANT <br /> 0 TIERED PERMITTED FACILITY ❑MOTEIIHOTEL ❑PUMPER TRUCK/YARDICHEIACALTOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOLISPA D LAND USE APPLICATION SiTES <br /> ❑ MEDICAL WASTE FACILITY Q COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> W ELL AND SEPTIC PERMIT RE.CORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 6:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to ton-addresaga Ir the apace above. Select the type(s)of files from the Ilst above by checking the appropriate <br /> box(es). At least one filet fps MUST be selected. Fa_x to(2091464-0138 er mail to the address Indicated above. Address <br /> ranges will not be accepts I-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 ap [cant if any EHD files exist. An appointment for review will be conflrTned approximately ten(10) <br /> days after receipt of applic ation. The files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled acco dingly. <br /> 3. A file 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 Is Rvailable. <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 III Is reviews by the tame applicant may require a$126 deposit prior to review. <br /> E D40-M I r —. _.--- e11r11 <br /> Received TimeApr1 5. 201 5:30PM No. 5904 <br />