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RECEIVED <br /> SAN J O A Q U I N ,, Health Department <br /> COUNTY-- � ' jnvironmental <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> EhM <br /> - �i��._ '�.�..� kµ19 <br /> . EHD LOG NUMBER. <br /> APPLICANT: Jackie Hyman BUSINESS/AGENCY:Advanced GeoEnvironmenlal Inc. <br /> ADDRESS: 3335 East Miraloma Avenue,Suite 142 CITY/STATE/ZIP:Anaheim,CA 92806 <br /> PHONE(1): 800-511-9300 PHONE(2): FAX OR E-MAIL: jhymanradvgeoenv.com <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact t rrange an appointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT DATE 22 May 2018 <br /> 1. List up to ten addresses in thefoace&elow. 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(a-)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 to <br /> ENVIRONMENTAL FILE ADDRESS co -1-o Dlcrn `L l—p ir <br /> HEALTH DEPARTMENT ( p y 9 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 /> Q Other Cleanup Site(Non-LOP) 1 4646 Quantas Lane, Units B9 Stockton <br /> • n Hazardous Waste <br /> ❑DAIRY <br /> Q Tiered Permitted Facility (A 2 4646 Quantas Lane, Units B10 Stockton <br /> 0 Aboveground Tank ���), <br /> Q UST (Monitoring/Removal) ❑PWS <br /> Q Hazardous Materials 3 4646 Quantas Lane Stockton <br /> Q Spill/Release Response <br /> ❑, ATER QUALITY <br /> Solid Waste Facility/Vehicle 4 <br /> F]Food Facility Hh (�✓ <br /> F]Pool/Spa [9SITE MITIGATION <br /> F]Dairy 6 PRO;-NEM <br /> ❑Land Use Application Sites <br /> ❑HOUSING <br /> ❑Septic Pumper Truck/ 6 <br /> Yard/Chemical Toilets �( -1�1✓ -(��, <br /> Wastewater Treatment Plant lgCUPA <br /> ❑Housing Abatement 7 AST/HM/HW <br /> F�Motel/Hotel <br /> F]Chicken Ranch/Dog Kennel ©CUPA <br /> F]Medical Waste Facility 8 UST <br /> Tattoo/Body Piercing ❑SOLID WASTE <br /> F]Waste Tire 9 <br /> F]Complaint <br /> Other(Please Specify): ❑ACCOUNTING <br /> 10 <br /> ***BOXED AREA-EHD USE ONLY*** <br /> Rb-vim 1C <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 209 464-0138 1 www.sjcehd.com <br />