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0712612013 13:58 SAX) P-0011002 <br />DATE RECEIVED SAN JOAQUIN COUNTY <br />� END LOG NUMBER <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />)�1 �j 2qITielephiione: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd ' <br />PUBLIC RECORDS RELEASE APPLICATION <br />D" <br />40� <br />APPLICANT: Rebecca Natal <br />BUSINESS/AGENCY: Advanced GeoEnvironmental <br />ADDRESS: 837 Sh9w Road CITY/STATE/ZIP: Stockton / CA / 95215 <br />PHONE (1): 209-467-1006 PHONE (2): 209-623-7200 FACSIMILE: 209-467-1118 <br />TENTAT/VE"APPOINTMENT DATE: ASAP Time: <br />(Please allow 10 business days from date of application submittal -"Tentative only -must be con rm.d) <br />❑ <br />CHECK BOX TO EXPEDITE RE <br />&UqST-$125FEE A OR CHECK ONLY) -REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT � P DATE 13 <br />Electronk; Information: ■ List ■ <br />..EHD <br />U$r; ONLY <br />,U <br />> <br />a►! 1► U� F.Jib .1 <br />1111111!; VA rIT, <br />ot <br />1 _: 11 1k' U►llr�� '� ►. Y t <br />MRA MA M <br />, 10M PAP <br />0 <br />WMI �► <br />1t J..JI •& <br />MCIF <br />fro. �'� til � 6 0t,JWET <br />t �ul��� <br />2ei�r�l�.��L[�uti�s➢ � <br />09 <br />mom <br />a 6.... - a Pr .i . BET IV. 1 [► a , <br />rj <br />00MR)MOIN <br />' <br />(0) <br />Specific Date Range of Information Requestad: From all � _ to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />x❑ UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT 0 SOLID WASTE FACILIT, NEHICL <br />x❑ OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY ❑x WASTE TIRE <br />X7 UNDERGROUND TANK (MONITORING/REMOVAL),-j,_ ❑ DOG KENNEL [k] DAIRY <br />Q HAZARDOUS WASTE GENERATOR,/ ❑ CHICKEN RANCH' ❑ WASTEWATER TREATMENT PLANT <br />Q TIERED PERMITTED FACILITY ; ❑ MOTEL/HOTEL ❑ PUMPER TRUCK/YARDICHEMICAL TOILETS <br />❑ TATTOO/BODY PIERCING ❑ POOL/SPA Q LAND USE APPLICATION SITES <br />❑ MEDICAL WASTE FACILITY ❑ COMPLAINT RECORDS ❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:00PM (EXCLUDING HOLIDAYS) <br />1, List up to ten addresses in the space above. Select the type(e) of files from the list above by checking the appropriate <br />box(es). At least one file typo MUST be selected. Fax to (209) 464-0138 or mail 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 (1 D) <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 2atively being worked on by EHD staff may not be Immediately available for review. A new application may be <br />submitted when the file 19 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 $125 deposit prlor to review. <br />CHO USE ONLY <br />o <br />EMD45-06 k l IL ("" ^ .7ci I 0 _(,o(,!/o, - �)., c� aN111 <br />Received Time Jul.26, 2013 1:54PM No. 3696 <br />