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r 0711212013 10:59 ") <br />DAFtE6EIVED <br />■ _ SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />JUL .�_ 2013 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />EN RP0'�0Mi -hal AL iE�!T9 } <br />PE,I n�fl�ioIIGES <br />r <br />PUBLIC RECORDS RELEASE APPLICATION <br />P.0011001 <br />END LOG NUMBER <br />"a '), - I <br />99;_1 tkt� <br />it I <br />APPLICANT: Ally Colavita 6USINESSIAGENCY: Advanced GeoEnvironmental <br />ADDRESS: 837 Shaw Road CITYISTATE/ZIP: Stockton / CA / 95215 <br />PHONE (1): 209-467-1006 PHONE (2): 209-483-3401 FACSIMILE: 209-467-1118 <br />TENTATIVE' APPOINTMENT DATE: ASAP i Time: <br />(Please allow 10 business days from date of application submittal - *Tentative only - must be confirmed) <br />❑ CHECK BOX TO EXPEDITE REQUEST - 125 FEE (C 0 H K ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT DATE 7/12/13 <br />Electronic Information: ❑ List ❑ Map —Description: <br />FILE ADDRESS <br />EHD USE ONLY <br />Unit 1 <br />Street # <br />Street Name city <br />1• <br />20500 <br />HOLLY DRIVE TRACY IN J <br />11JT, <br />]Unit 2 <br />9409 <br />WEST ARBOR AVENUE TRACY <br />3. <br />171 Unit <br />4. <br />0 Unit <br />g• <br />7. <br />~ <br />Unit 6 <br />e• <br />`� p'Unit I3 <br />10. <br />Specific Date Range of Informatlon Reque2ted: From all to <br />ENVIRONMENTAL. HEALTH DEPARTMENT FILES <br />x❑ UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITYNEHICLE <br />x❑ OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY ❑x WASTE TIRE <br />Q UNDERGROUND TANK (MONITORING/REMovAL) ❑ Doa KENNEL n DAIRY <br />x❑ HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH Q WASTEWATER TREATMENT PLANT <br />u TIERED PERMITTED FACILITY ❑ MOTEL/HOTEL ❑ PUMPER TRUCKIYARD/CHEMICAL TOILETS <br />❑ TATTOO/BODY PIERCING ❑ POOLISPA D LAND USE APPLICATION SITES <br />❑ MEDICAL WASTE FACILITY Q COMPLAINT RECORDS ❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-6:00PM (EXCLUDING HOLIDAYS <br />1. List up to tan addreaaea In the space above. Select the type(*) of file* from the list above by checking the appropriate <br />box(os). At least one file type MUST be selected. Fax to (209) 484-0138 or all to the address Indinatad above. Address <br />ranges will not be accepted - for additional aeolstance with fila 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 file that Is actively being worked on by EHD staff may not be Immediately available for revlew. A new application may be <br />submitted when the file is available. <br />4. Any flle not returned In the same condition as rete asod will be reorganized by EHD staff at the expense of the applicant. <br />Future file reviews by the same applicant may require a $125 deposit prior to review. <br />EHD USE ONLY <br />RTeeiwed Time Jul. 12. 2013 10:54AM No.3577 e <br />