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0311612011 08:39 Advanced GeoEnviromental Inc. 4671118 P.0011001 <br /> ( �'iVuti�d FI1D LOG NUMBER <br /> Hf"i I��N�I^a O�intY SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> lGQZ �. dV1!'.I 600 East Main St. Stockton, CA 95202-3029 Q <br /> Telephone: 209 468-3420 Fax: (2 <br /> 09)( ) ( 09) 464-0138 Web: www.sjgov.org/ehd <br /> I 03 PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: AII)I Colavita BUSINESS/AGENCY:Advanced GeoEnyirnnmantal <br /> ADDRESS: 837 Shaw Road CITYISTATFJZIP:_Stockton/CA/95215 <br /> PHONE(1): 209- 167-1006 PHONE (2):209-483-3401 _ FACSIMILE: 209-457-1118 <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-'Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$1FEE A OR CHECK ONLY)-REOUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ( .1 �L DATE <br /> Electronic Information: ❑ List❑ Map,Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street Street Nam@ City Unit 1 <br /> 2. � _��7� - <br /> �� 1\ h <br /> �.g nit.2. - — — <br /> 3. ,Z'0Qg$— �. L1 U ,� I 7 <br /> 4. g <br /> -6.6. <br /> nit4 <br /> 7. <br /> 8. <br /> Unit d <br /> 10. <br /> nit& <br /> Specific Date Range of information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ®SOLID WASTE FACILITYNEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑F000 FACILITY ®WASTE TIRE <br /> UNDERGROUND TANK(MONrroRING1REMOVA ❑Doo KENNEL ❑DAIRYj j <br /> ® <br /> HAzARvous WASTE GENERATORS ❑CHICKEN RANCH ®WASTEWATER TREATMENT PLANT <br /> ®TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TAT7001BODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ® MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-6:OOPM(EXCLUDINe HOLIDAYS) <br /> 1. List un to ten addresses in the space above. Select the type($)of files from the list above by checking the appropriate <br /> box(ee). At feast one file type MUST be selected. Fax to(209)464-0138 or mall to the address indicated above. Address <br /> ranges will not be accepted-for addltlonal 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 EHD filos exist. An appointment for review will be cvnfirmed approximately ten(10) <br /> days after receipt of application. The filea will be held for a maximum of five business days for review. Appointments <br /> should be achaduied 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 le 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$115 deposit prior to review. <br /> G. If you need further aseiatanee,please contact Diane Martinez,at(205)468-3426. <br /> RHDU311 NLY <br /> 3- 0 Lr m L-o <br /> r <br /> EHD 46.08 }(Ir z r` () 2' <br />