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REGEIVED <br /> SAN J 0 A Q U I NUN 2 5 2018 Environmental Health Department <br /> --COU N T Y--- PAFUBLIC RECORDS RELEASE APPLICATION <br /> - .. F.tMFiIO.PDUtE1ffAt.FfM*. y' <br /> ♦0 <br /> PEMMRI IV�IT BY EMAIL <br /> • EHD LOG NUMBER. 52. <br /> APPLICANT: Rebecca Natal BUSINESS/AGENCY:Advanced GeoEnvironmental,Inc <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP:Stockton,CA 95215 <br /> PHONE(1): 209-467-1006 PHONE(2):209-623-7200 FAX OR E-MAIL: Rnatall�iadvgeoenv.com <br /> Please allow 10 business days from date of application submittal or the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT DATE C. szuta <br /> 1. List up to ten addresses in the space below. Address ranges WILL NOT be accepted. Select the type(s)of files from the <br /> list below by checking the appropriate box(es). At least one file type MUST be selected. Fax to (209)464-0138,mail to the <br /> address indicated below,or email to info(a)slcehd.com. Applications received after 3:00 pm will be processed the next <br /> business day. <br /> 2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted below. <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$152 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM•5:OOPM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS -to <br /> HEALTH DEPARTMENT <br /> A7f Nil Ir <br /> FILES (Specific addresses only,address ranges will not be accepted) EHD USE ONL <br /> ❑X Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) ❑CONSUMER <br /> 1 1850 E Louise A rop <br /> • X Other Cleanup Site(Non-LOP) ►,Irl D <br /> QX Hazardous Waste No D5 DAIRY <br /> Tiered Permitted Facility 01 '2112 E Louise Ave Lathrop 00-tmwc q; w <br /> ❑x Aboveground Tank � Lv�" <br /> FX UST (Monitoring/Removal) ~ i/4 �VU; 1 irmp ❑PWS <br /> 3 yHazardous Materials 1700 E Louise Ave Lathrop <br /> n1 <br /> ❑X Spill/Release Response <br /> 1{ril NN <br /> Solid Waste Facility/Vehicle 4 2050 E Louise Ave Lathrop hI-T N��" �f SrER QUALITY <br /> Food Facility Itka <br /> Pool/Spa Q16TE MITIGATION <br /> Dairy 5 <br /> FX_I Use Application Sites <br /> ❑Septic Pumper Truck/ 6 E)HOUSING <br /> Yard/Chemical Toilets <br /> QX Wastewater Treatment Plant UPA <br /> Housing Abatement 7 AST/HM/HW <br /> ❑Motel/Hotel <br /> ❑Chicken Ranch/Dog Kennel Ej(CUPA <br /> Medical Waste Facility $ UST <br /> Tattoo/Body Piercing ❑SOLID WASTE <br /> ❑Waste Tire 9 <br /> Q Complaint <br /> Other(Please Specify): ❑ACCOUNTING <br /> 10 <br /> ***BOXED AREA-EHD USE ONLY*** <br /> t"'Ill k,. Y r- �- <br /> n <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: EHD48-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 F 209 464-0138 1 www.sjcehd.com <br />