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CEIVED <br /> SAN J QA Q Environmental Health Department <br /> C O U N T�'-- -JUN 12 201 PUBLIC RECORDS RELEASE APPLICATION <br /> ENVIRONMENTALI BY EMAIL <br /> PERMIT/SER\? (D-13 Y,,' . � a <br /> • EHD LOG NUMBER. <br /> APPLICANT: Rebecca Natal BUSINESS/AGENCY:Advanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP:Stockton California,95215 <br /> PHONE(1): 209-467-1006 PHONE(2):209-623-7200 FAX OR E-MAIL: Rnatal@advgeoenv.corn <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 r+ <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 infogsicehd.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 ngted 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. <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 2CD P�C�J a et <br /> HEALTH DEPARTMENT ( p y g p <br /> FILES (Specific addresses only,address ranges will not be accepted) EHD USE ONLY <br /> Q Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) ❑CONSUMER <br /> ❑X Other Cleanup Site(Non-LOP) 1 1931 E Oak St Stockton <br /> • X Hazardous Waste <br /> Flora Waste []DAIRY <br /> X Tiered Permitted Facility2 1722 E S t Stockton f�� <br /> ❑X Aboveground Tank <br /> ❑X UST (Monitoring/Removal) PWS <br /> Q Hazardous Materials 3 1903 E Fremont St Stockton <br /> [E Spill/Release Response ) _ <br /> 1960 I�S t <br /> ❑Solid Waste Facility/Vehicle 4 E Fremont St Stockton WATER QUALITY <br /> ❑ Food Facility <br /> ❑ Pool/Spa I.�t{w E MITIGATION <br /> F-] Dairy 5 1908' E Fremont St Stockton ' <br /> FXJ Land Use Application Sites _ <br /> r]Septic Pumper Truck I ❑HOUSING <br /> 6 2001 E Fremont St Stockton <br /> Yard/Chemical Toilets <br /> ❑X Wastewater Treatment Plant HP�11W�S( VUPA <br /> Housing Abatement 7 2010 E Fremont St Stockton sr/k, AST/HM/HW <br /> ❑ Motel/Hotel <br /> ❑Chicken Ranch/Dog Kennel 1{�il�y� CUPA <br /> ❑ Medical Waste Facility 8 2040 E Fremont St Stockton UST <br /> ❑Tattoo/Body Piercing ❑SOLID WASTE <br /> ❑Waste Tire 9 <br /> ❑X Complaint <br /> ❑Other(Please Specify): ❑AccouNTING <br /> 10 <br /> ***BOXED AREA-EHD USE ONLY*** <br /> • ��—� '..j;thwl�r Ae1rA <br /> � 1 txo fz —5 LQ U S <br /> — 1 <br /> ❑ Records provided by Staff-PPR Complete. staff Name: 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 />