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RECEIVED <br /> SAN J OAQ U I N Environmental Health Department <br /> -- C C U N T`T — -- MAY 18 s016 PUBLIC RECORDS RELEASE APPLICATION <br /> 'EW MAIL r2ww' ���, <br /> • PM T/SE rf2J EHD LOG NUMBER. <br /> APPLICANT: Rebecca Natal BUSINESS/AGENCY:Advanced GeoEnviron men tal,Inc <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP:Stockton.CA 95215 <br /> PHONE (1): 209-467-1006 PHONE (2):209-623-7200 FAX OR E-MAIL: Rnatal@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 /> SIGNATURE OF APPLICANT DATE t;1 z l <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 info(�slcehd.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 noted 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 = t to a01a <br /> ENVIRONMENTAL FILE ADDRESS ADVO <br /> HEALTH DEPARTMENT 9 accepted) EHD USE ONL I' <br /> FILES (Specific addresses only,address ranges will not be acce ted <br /> Q Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) CONSUMER <br /> Q Other Cleanup Site(Non-LOP) 1 1 300 E Louise Ave Lathrop /� <br /> 0 Hazardous Waste +✓ ( COO DAIRY <br /> QX Tiered Permitted z 500 E Louise Ave Lathrop °� <br /> Q Aboveground Tank t��l v1y` S <br /> Q UST (Monitoring/Removal) PWS <br /> Q Hazardous Materials 3 <br /> Q Spill/Release Response <br /> ATER QUALITY <br /> Solid Waste Facility/Vehicle 4 <br /> Ej Food Facility <br /> $ITE MITIGATION <br /> Pool/Spa <br /> R Dairy 5 <br /> Q Land Use Application Sites <br /> HOUSING <br /> F]Septic Pumper Truck/ 6 <br /> Yard/Chemical Toilets <br /> Wastewater Treatment Plant AA <br /> F] Housing Abatement 7 <br /> El Motel/Hotel <br /> Chicken Ranch/Dog Kennel <br /> g <br /> ❑Medical Waste Facility <br /> Tattoo/Body Piercing❑Waste Tire 9 <br /> Q Complaint <br /> Other(Please Specify): <br /> 10 <br /> � f ***`BOXED AREA-EHD USE ONLY <br /> • �-7"ltYa'tC'' ~vNo' &l'u\ I. ,LvY`�'t-1lri C� .file"• A ,"�ki'r\k ^"t'1 09j W[-tai• Gyl1l� F.✓r.�f�kLt (I'' `OC%c� <br /> 3 2 <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: EHD 48-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209464-0138 1 www.sjcehd.com <br />