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08/1612017 12:29 (FAX) P.0021002 <br /> D I E SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> AUG � ,, <br /> ' 414 ENVIRONMENTAL ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1 B68 East Hazelton Avenue, Stockton, CA 85205-6232 <br /> Ir M114W&BALI-�AL�Telephone: (209) 468-3424 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> PEMAITISERMW5 PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT; Rebecca Natal SUSINESSIAGENCY:Advanced GeoEnvironmental, Inc, <br /> ADDRESS: 837 Shaw Road CITYISTATEIZIP.Stockton, CA 95215 _ <br /> PHONE (1); 209-467-1006 PHONE=(2):209-623-7200 FAX DR E-MAIL: rnatal@adygeoenv.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 /> Q CHECK BOX TO EXPInDITE REQUEST-$138 F E(CASH ORCHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 08/16/2017 <br /> 1. list up_W tan addresses in the space below. —I colt,t e ty e(a)Affles from the list below by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to (209) 4-0138 or mail to the address Indicated above. Address <br /> rangers will not be accepted.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance In Identifying the nature and content of EHD records, please contact EHD at the number noted above. <br /> 3. The EHD will notify the applicant If any EHD flies exist. An appointment for review will be confirmed approximately ten (10) <br /> days after receipt of application. The flies 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. t <br /> Future file reviews by the same applicant may require a $139 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List ❑ Map—Description: <br /> SpeclfIc Date Range of Information Requested: From to <br /> ENVIRONMENTAL <br /> HEALTH FILES <br /> FILE ADDRESS <br /> EHD USE ONLY <br /> []UNDFRo110LIND TANK(UST) Street d Street Name city <br /> CLEANUP S[TF(LOP) E]p CDNeuuER <br /> OTHER CLEANUP SITE(NoN•LOP) 1011 North Broadway Ave Stockton f 4 r Y l � <br /> C]HAZAROOIJS WASTE DAIRY <br /> p, Q <br /> I7 TIERED PERMITTED FACILITY 2 916 North Broadway Ave Stockton <br /> I1 ABovEOROVND TANK "' ✓p l 1 �� <br /> ®UST (MONITORINO I RriMOVAL) r❑FWS <br /> HA7.ARDOU$MATENJALS 3 <br /> rXj SPILURELEASE RESPONSE ,�,/' <br /> SOLID WASTE FACILITYI VEHICLE d Ly WA7EN QUALITY <br /> FOOD FACILITY <br /> ❑POOL!9F'A SIn MITW-WON <br /> DAIRY d ` <br /> LAND USE APPLICATION SITES /l <br /> n SEPTIC,PUMPER TRUCK I HOU81X0 <br /> 6 <br /> YARD I CHEMICAL TaLETS <br /> it WASTEWATYR TREATMENT PLANT UPA <br /> HOUSING ABATPMENT <br /> ®MOTMJHeTPL <br /> CHICKEN RANCH I DOo KdNNeL W CUPA-UST <br /> MPDICAL WASTP FACILITY 9 <br /> TATT=BODY PIARCIN4 <br /> ❑BvLlu WA1TE <br /> WASTE TURF <br /> 0 <br /> COMPLAINT <br /> []orrIIPR(PLeAsE sPPcIPY) <br /> ©A6C6UNT1Ne <br /> �3 <br /> '—BOXED AREA-EHQ USE ONLY"' <br /> �6. - �1 11 . 59�A f1 2109 <br /> u nva.uaa F. uJlt�e]'uy .o..9t -rr1t✓VIII tlly l[1. ��*T rvame= <br />