Laserfiche WebLink
0 <br /> I ® <br /> EHD LOG NUMBER <br /> BM L,, SAN JOAQUIN COUNTY <br /> 13 I FL tI IV <br /> Ira ENVIRONMENTAL HEALTH DEPARTMENT <br /> FEB r d 2015 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjsov.org/Ghd <br /> ENVIRONMENTAL HEALTH <br /> PERMITISERVICES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Yukari Hirayama BUSINESS/AGENCY:Advanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITY/STATEOP: Stockton/CA/95215 <br /> PHONE(1): 818-486-2150 PHONE (2):209-623-7200 FACSIMILE: 209-467-1118 <br /> TENTATIVE"APPOINTMENT DATE: Time: <br /> (Please allow 10 husiness days from data of application submittal-*Tentative only-must be confirmed) - <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 2/10/2015 <br /> Electronic Information: ❑ Last❑ Map—Description: <br /> FIRE ADDRESS EMD USE ONLY <br /> Street# - Street Name city unit <br /> 1• 1413 Bourbon Street Stockton 04 <br /> 1 LAO <br /> 2. 3755 West Lane Stockton 7-Unit2 <br /> 3. 3805 West Lane Stockton <br /> 4. I"` O-tit 3- <br /> _0-41t <br /> 6. <br /> 6. _p-41t 4 <br /> 8. li7V`elel (�.��ey w4a �W <br /> Unit 6 <br /> 9. Nit <br /> 10. <br /> Speclflc Data Range of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> X❑UNDERGROUNDTANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑x SOLID WASTE FACILITYNEHICLE <br /> x❑OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACIUTY ❑x WASTE TIRE <br /> X❑UNDERGROUND TANK(MONITORING/REMOVAL) ❑DOG KENNEL DAIRY <br /> x❑HAZAROOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> X❑TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPERTRUCKIYARDICHEMICAL TOILETS <br /> ❑TATTOO/BODY PIERCING ❑POOLISPA 0 LAND USEAPPUCATION SITES <br /> ❑ MEDICAL WASTE FACILITY 0 COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-S:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At least 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 additional 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 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 /> 3. A flle 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 is 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$1225 deposit prior to review. <br /> aV.aevl LO LAST J11,_ f h Isk 375'S ules­l L.J. <br /> Received Time Feb. 10. 2015 11 :45AM No, 8087 811„1 <br />