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® ■ gL <br /> a�DAT � �('^ To: Fax: (209)464-0736 Page 1 D( 1 03/1212018 9S0 AM <br /> o n rYr..i� SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ■ 9 6114 ENVIRONMENTAL HEALTH DEPARTMENT <br /> t <br /> 1. MAN 1 2 2018 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: wvvw.sjgov.org/ehd �(.�� '•i <br /> - EN1VIM At1EMALM,,.M_ PUBLIC RECORDS RELEASE APPLICATION <br /> AP— PLICANTJackie Hyman BUSINESS/AGENCY:Advanced GeoEnvironmental, Inc. <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP:Stockton, California 95215 <br /> PHONE(1): 800-511-9300 PHONE(2): FAX OR E-MAIL: jhyman@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 /> ❑ CHECK BOXTO EXPEDITE REQUEST-$139 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 03/12/2018 <br /> 1. List up to ten addresses in the space below. Select the type(s)of files from the list below by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mall to the address Indicated above. Address <br /> ranges 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 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 /> I4. Any file not returned In the same condition as released will be reorganized by EHD staff at the expense of the applicant. j <br /> • \4,> Future file reviews by the same applicant may require a $139 deposit prior to review. 3/{Lcjl) <br /> �9 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 <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES EHD USE ONLY <br /> O UNDERGROUND TANK(LIST) Street Street Name City <br /> CLEANUP SITE(LOP) �COX6VMER <br /> ' 435 North Harrison Street Stockton <br /> x 01NERCLEANUPSRE(NON-LOP) <br /> O HAZARDOUS WASTE ,1 An`H w DA RY <br /> F TIERED PERMITTED FACnm 2 fl1 - <br /> OABOVEGROUNDTANK <br /> O LIST (MONRORING/REMOVAL) PWS <br /> I]HAZARDOUS MATERIALS 3 <br /> O SPILURELEASE RESPONSE {�^ ��,,//�� //�L <br /> i]SOLID WAIT E FACILITY/VEHICLE 4 / Ll 1 -p- <br /> J / j' ^ M / I\ wlvm 4oaLrtr <br /> ❑FOOD FACILITY ' 1 ' 'r �l 'lY/ Y`-' <br /> POOL/SPA i A �,�/� 6ITEMMID"ON <br /> ❑DARY fi <br /> O LAND U SE APPLICATION S REB <br /> ❑S EPIC P LIMPER TRUCK/ _ �HOV6ING <br /> fi <br /> YARD/CHEMICAL TOILETS <br /> lXj WASTEWATER TREATMENTPLANT (4? CUPA <br /> HouSINGABATEMENT T C <br /> ❑MOTEL/HOTEL '" Zt��✓ <br /> ❑CHICKEN RANCH/DOG KENNEL CUPA UST <br /> ❑MEDICALWASfE FACILITY B <br /> ❑TATTOO/3ODY PIERCING <br /> $OLIO WABTF <br /> OWASTETIRE 9 <br /> O COMPLAINT <br /> OTMER(PLEASE SPECIFY): A.EOVNTNG <br /> 10 <br /> —BOXED AREA•EHD USE ONLY— <br /> it CiAl IR- kke-let( .v-br1 <br /> ❑ Records provided by Staff-PPR Complete. staff Name: <br /> Received Time—Mar, 12. -2018— 9 :44AM—No. 3202 <br />