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RECEIVED <br /> SANJOAQUIN Environmental Health Department <br /> --COUNTY--- <br /> 'SUN 2 6 2018 PUBLIC RECORDS RELEASE APPLICATION <br /> U ..Jtr1t55 hCEWRONMER ` <br /> MAIL <br /> PEWIT/111>PEWIT/111>11UII� 9 0G3 <br /> • � < " EHD LOG NUMBER: �� <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):209-467-1118 FAX OR E-MAIL: Rnatal@advgeoenv.com <br /> Please allow 10 business days from date of application submittal for 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 zen <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(cDslcehd.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$152 deposit prior to review. �n <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List ❑ Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS l0 ZR 1e <br /> HEALTH DEPARTMENT ( p y 9 accepted) EHD USE ONLY <br /> FILES (Specific addresses only, address ranges will not be acce ted <br /> Q Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) ' � I t l�P 1 �s$as �CONSUMER <br /> ❑X Other Cleanup Site(Non-LO <br /> S McKinley Lathrop <br /> ❑Hazardous Waste ❑DAIRY <br /> ❑Tiered Permitted Facility 2 _ <br /> ❑Aboveground Tank <br /> FX UST (Monitoring/Removal) ❑PWS <br /> 3 <br /> Hazardous Materials <br /> Q Spill/Release Response <br /> ATER QUALITY <br /> Solid Waste Facility/Vehicle 4 <br /> Food Facility <br /> Pool/Spa SITE MITIGATION <br /> Dairy <br /> 5 <br /> n Land Use Application Sites <br /> ❑HOUSING <br /> F]Septic Pumper Truck/ 6 <br /> Yard/Chemical Toilets <br /> Wastewater Treatment Plant ® UPA <br /> F]Housing Abatement 7 AST/HM/HW <br /> F]Motel/Hotel <br /> El Chicken Ranch/Dog Kennel ® UPA <br /> 8 UST <br /> Medical Waste Facility <br /> n Tattoo/Body Piercing ❑SOLID WASTE <br /> 171 Waste Tire 9 <br /> Complaint <br /> Other(Please Specify): ❑ACCOUNTING <br /> 10 <br /> —BOXED AREA-EHD USE ONLY*** <br /> Ann. P <br /> • (�to/2-cf1iff rffnfilaint S C GDlD5Y9 o 9 5 <br /> Tr9IPL094' 2,LiH <br /> ❑ Records provided by Staff PPR Complete. staff Name: n EHD 48-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />