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11/13/2012 09:20 Advanced GeoEnviromental Inc. TAX)209 4671118 P.0011001 <br /> - D CEIVED FJ-ID LOG NUMBER <br /> V - <br /> ®® �EIVE� SAN aIOAQUIN COUNTY <br /> R ENVIRONMENTAL HEALTH DEPARTMENT '✓ <br /> NOV $ ZQ 1868 East Hazelton Avenue, Stockton, CA 95205-6232V 4ti✓ <br /> telephone: (209)468-3420 Fax: (209) 464-0138 Web:www.sjgov.org/ehd , , <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICA710N <br /> APPLICANT. Ally Colavita BUSINESS/AGENCY: Advanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITY/STATEIZiP: Stockton /CA/ 95215 <br /> PHONE(1): 209-467-1006 PHONE(2): 209-483-3401 FACSIMILE: 209-467-1118 <br /> TENTATIVE"APPOINTMENT DATE: qSAP Time: <br /> (Please allow 10 business days from date of application submittal-•TentWva only-must be confirmed) <br /> ❑ CHECK BOX To EXPEDITE REOUF_ T 5 F E(CASHk)R CH <0 •R QUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT C J ��/-�t a DATE 11/13/12 <br /> Electroniclnformatlom ElList® Map—Description: <br /> FILE ADDRESS CHD USE ONLY <br /> Street# Streat Name City ,Ej Unit9 <br /> 1. 1100 South Main Street Manteca �`> I. <br /> 2. 1103 South Main Street Manteca P6 I Unit <br /> ZJ 3• 555 Industrial Park Drive Mantecav M Ncu�fh �l <br /> 4• 544 Industrial Park Drive Manteca y �Unit3 <br /> 5. <br /> a. unit 4 <br /> 7. <br /> S. Q Um140 <br /> 9. <br /> 10. aan94© <br /> Specific Date Range of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> Q UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOuSNG ABATEMENT ElSOLID WASTE PlA01 HIc E <br /> TYIVE <br /> •OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY fD WASTE TIRE)P�T6�s <br /> •UNDERGROUND TANK(MONITORINGIREMOVAL) [_1 DOG KENNEL 0 DAIRY <br /> E]HAZARDOUS WASTE GENERATOR F—]CHICKENRANCH ❑WASTEWATER T4EATdENT tFUNT/ _( <br /> Q TIERED PERMITTED FACILITY ❑MOTEIIHOTEL ❑PUMPERTRucKr ARDICHEMICAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOU$PA I]LAND USE APPLICATION SITES <br /> ® MEDICAL WASTE FACLTTY ®COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 5:00 AM.&OOPM(EXCLUDING HOLIOAY5) <br /> 1. List uo to ton addresaeq In the space above. Select the type(*)of flies from the list above by checking the appropriate <br /> box(es). At least one filo type MUST be selected. F to 1229)464-0138 or mall to the address Indicated above Address <br /> ranges will not be accepted-for additional aselstance with file addressee,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 file*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 /> 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 available. <br /> 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the expellee of the applicant. <br /> Future file reviews by the name applicant may require a$128 deposit prior to review. <br /> 11,11-L4, Iwo r' 33C <br /> 0 kl— )A N U T C - <br /> 2 <br /> -- D rnnl <br /> Received Time Nov. 13. 2012 9: 16AM No. 1610 <br />