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r Advanced GeoEnvimiFax:(7077)670-1461 To: Fax: +1 (209)464-0138 Page 1 of 1 12/042015 3:47 PM <br /> ■DATE RECEIVED EHD LOG NUMBER <br /> 1 ■ r - c ., � A SRN JOAQUIN COUNTY <br /> e e �! --, ENVIRONMENTAL HEALTH DEPARTMENT ] <br /> • 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> OEC 07 2015 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br /> ENVIRONf�iEirl AL HFJ�( � <br /> PERff1lT!uEWlr;ES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Rebecca Natal BUSINESS/AGENCY: Advanced ranFnvironmantai <br /> ADDRESS: 837 ShatA7 Road CITY/STATE/ZIP: gtnrktnn / CA / 9579 r, <br /> PHONE(1): 209-467-1006 PHONE(2): FACSIMILE: 209-467-1118 <br /> TENTATIVE"APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED INS BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City M16/lit 1 <br /> 1. linn IiFt <br /> 3. 17 <br /> _ uli,;t 3 or <br /> 4. 2""'3 1/1 J <br /> 5. 1 <br /> s. PAN4a(0File Icv1®/U/nt4 <br /> 7. 0(o0n <br /> 8. <br /> QU/nit 5 <br /> 9. <br /> 10. �11 V{Uii �" .dV• <br /> ��UnFt-6' <br /> Specific Date Range of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> x❑UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑x SOLID WASTE FACILITYNEH]CLE <br /> X❑OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑x WASTE TIRE <br /> Q UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL Q DAIRY <br /> RI HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> O TIERED PERMITTED FACILITY ❑MOTEL/HOTEL ❑PUMPER TRUCK/YARD/CHEMICAL TOILETS <br /> ❑TATTOO/BODY PIERCING ❑ POOL/SPA Q LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑x 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(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type 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 (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 /> 3. Afile that is actively being worked on by EHD staff may not be immediately available for review. A new application may be <br /> submitted when the file is available. <br /> 4. Anyffle 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 prior to review. <br /> "U__ <br /> (q k C O 1 U (SNi s' " V A� X61 1 o; N r <br /> T ,A 61) rof i.90 L <br /> Received Time Dec. 4, 2015" 3.47PM�No. 0128 6""' <br />