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RECEIV�RSAN-JOAQUINronmental Health Department <br />i ---COUNTY MAY 0 S 2018 PUBJIC RECORDS RELEASE APPLICATION <br />ryEWR <br />• PEt�MIT EHD LOG NUMBER: 8f3 -7;L!; <br />APPLICANT: Jackie Hyman BUSINESS/AGENCY: Advanced GeoEnvironmental <br />ADDRESS: 3335 East Miraloma Avenue #142 CITY/STATE/ZIP: Anaheim, CA 92806 <br />PHONE (1): 800-511-9300 PHONE (2): FAX OR E-MAIL: jhyman@advgeoenv.com <br />Please allow 10 business days from date of application submittal for the records to be available. <br />Staff will contact to rrange an appointment date and time to review the requested records. <br />SIGNATURE OF APPLICANT DATE 08 Nla% 2018 <br />1. List up to ten addresses in the ce low. Address ranges WILL NOT be accepted. Select the type(s) of files from the <br />list below by checking the appropriate ox(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(d)sicehd 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 June 2017 to <br />f <br />�i <br />r: <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />FILES <br />(Specific addresses <br />FILE ADDRESS <br />only, address ranges will not <br />be accepted) <br />EHD USE ONLY <br />0 Underground Tank (UST) <br />Street # <br />Street Name <br />City <br />1 <br />QQ <br />88 1 <br />Shaw Road <br />Stockton <br />CONSUMER <br />�4�'' w SP ❑ <br />Cleanup Site (LOP)Q <br />Q Other <br />❑X Hazardous Waste <br />FX Tiered Permitted Facility <br />Q Aboveground Tank <br />2 <br />❑ DAIRY <br />❑ PWS <br />QX UST (Monitoring / Removal) <br />❑X Hazardous Materials <br />s <br />❑X Spill / Release Response <br />4 <br />[9WATER QUALITY <br />0 Solid Waste Facility / Vehicle <br />F] Food Facility <br />SITE MITIGATION <br />n Pool / Spa <br />❑ Dairy <br />6 <br />n Land Use Application Sites <br />6 <br />❑ HOUSING <br />Septic Pumper Truck / <br />Yard / Chemical Toilets <br />Wastewater Treatment Plant <br />Housing Abatement <br />7 <br />CUPA <br />AST / HM / HW <br />Motel/Hotel <br />8 <br />tjCUPA <br />UST <br />Chicken Ranch / Dog Kennel <br />Medical Waste Facility <br />Tattoo/Body Piercing <br />Waste Tire <br />g <br />SOLID WASTE <br />Complaint <br />E] Other (Please Specify): <br />10 <br />❑ AccouNTING <br />BOXED AREA - EHD USE ONLY`** <br />D Au s c0R0aYF d- 0/5 s <br />❑ Records provided by Staff -PPR Complete. stair Name: EHD 48-06 <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.coin <br />1169 <br />