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RECEIVED <br /> SANtJQAQUIN MAR 23 2018 Environmental Health Department <br /> ---C O U N TY--- PUBLIC RECORDS RELEASE APPLICATION <br /> ENVIRONMENT 7 <br /> `_) r,cntrss urGP.5 he e. IRONPERMEN '�PAm'- na �j <br /> EHD LOG NUMBER: q v� <br /> APPLICANT: Rebecca Natal BUSINESS/AGENCY:Advanced GeoEnvironmental,lnc. <br /> ADDRESS: 837 Shaw Road C ITY/STATE/ZIP:Stockton,California 95215 <br /> PHONE(1): 209-467-1006 PHONE(2):209-623-7200 FAX OR E-MAIL: rnatal@advgwenrv.wm <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrang n ppout datp a time to review the requested records. <br /> SIGNATURE OF APPLICANT j ' �( DATE 3/2312018 <br /> 1. List up to ten addresses in the space below. Address ranges W LL 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)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 to <br /> ENVIJAENTAL FILE ADDRESS <br /> HEALTHARTMENT <br /> S (Specific addresses only,address ranges will not be accepted) HD USE ONLY <br /> FX Undergronk(UST) Street# Street Name CityCleanup OP) 3805 West Lane Stockton w �P eS °c-=aMERXJ Other Cleite(Nan-LOP) PQ Hazardouter� " ° Sx❑Tiered PeFacility 2 621 N Broadway Ave StocktonFX AbovegronkUST (Mo /Removal) /n� �" °PWS <br /> Q Hazardourials 3 -' )C-� r 0001 r7XJ Spill/ReleaseResponse �L � <br /> • „n q,,, I 0�l . WAI Ounun <br /> Solid Waste Facility/Vehicle 4 IV``�Y`••�IW [�1 <br /> ❑Food Facility <br /> ❑Pool/Spa <br /> ❑Dairy 5 <br /> QX Land Use Application Sites <br /> ❑Septic Pumper Truck/ ❑6 Houslua <br /> Yard/Chemical Toilets <br /> Wastewater Treatment Plant ig"CUPA <br /> Housing Abatement 7 ASTI HM I HW <br /> Motel/Hotel <br /> Chicken Ranch/Dog Kennel UPA <br /> B <br /> Medical Waste Facility UST <br /> Tattoo/Body Piercing <br /> 0.10 WASTE <br /> QWaste Tire g <br /> N Complaint <br /> Other(Please Specify): ❑Acwuurinc <br /> 10 <br /> * BOXED AREA-EHD USE ONLY* <br /> -1 - `✓w v PP �'L. R Oj w <br /> D Records provided by Staff-PPR Complete. Staff Name: Flip Is-os <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />