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' e 1012812015 09:02 (FAX) r.uvuvuI <br /> is <br /> Ie <br /> lmata RFECE&I f " EHD LO.G NUMBER <br /> IM� ` t`� SAN �OAC�UiN COUNT!. . <br /> OCT 28 2015 ENVIRONMENTAL HEALTH DEPARTMENT P7 A <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ENVIRONMENTAL HEAJAlephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> PERMIT/SERVICE PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Jennifer Berilklan BUSINESSIAGENCY:Advanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITYISTATEIZLP:Stockton,CA 95215 <br /> PHONE (1): 209467-1006 PHONE(2)L 209-48334!11 FACSIMILE:209-067-1118 <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 BOX TO EXPEDITE REQUE CASH OR CHECK ONLY)-REQUEST PROCESSED IN INE�S DAYS <br /> SIGNATURE OF APPLICANT OATE 0 <br /> Electronic Information: ❑ List Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> M_ Street# Street Name City - <br /> 1. 825 Navy Drive Stockton GtiEv�-Ce�,� <br /> 2. 1137 South Stockton Street Stockton Cttt,+.+�-� &V rr/ Ont 1 <br /> 3. 1240 Navy Drive Stockton (%eVL'-[� }1 L❑ n t2 J (� <br /> 4. 1145 West Charter Way - Stockton �Leh.'fo/ � `�,•� •tr 1`1// <br /> 5 939 West Charter Way Stockton —C*3 i J <br /> 6. LA,S-1 -Lo P 1zGn J nit3 <br /> r07 J.O 915nit4 <br /> nit 6 <br /> 9peclflc Data Range of information Requested: Pram to <br /> ENVIRONMENTAL HEALTk DEPARTMENT FILES <br /> ©UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILrrY SOLID WASTE FACILaYNEHICLE <br /> � HOUS!HO P.BATEMEN! ©'WA6TE TIRE <br /> ZOTHER CLEANUP SITE(NON•LOP) ❑ <br /> [k2 t)NDERGROUND TANK(MONITORixoIRENOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ©9BOVEGROUND TANK ❑CHICKEN RANCHI DOG KENNEL ❑WASTEWATERTREATMENT PLANT <br /> AZARDOUS WASTEIHAZARDOUS MATERIALS ❑MDTELIHDTEL ❑PUMPER TRUCKIYARDICHEMTGAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑ LISPA ElLAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING _ Q CONPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELLANDSEP71CPERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY•FRLDAYB:OOAM-5:OOPM(EXCLUDtNGHOUDAYS) <br /> 1, i jat u0 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 fila type MUST be selected. Q" Dens II r theaddress 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 flies exist.An appointment for review will be confirmed approximately ten(10) <br /> days atter reeelpt 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 lite not returned In the same condition as released x411 be reorganized by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$130 deposit prior to review. --p9Ac2ABg -EHD USE ONLY— <br /> �J� CLeb Y 015+ 1140 !k 1131 Skadci R 114 U mT t) ti <br /> ItK CI„a t. CA. e�9u1 t pn f X$ <br /> t }tivo n)w t r -t ee, IIL4 <br /> (ot- I t 1)S tip In 4 X$T We for <br /> AtLv fit. <br /> CO I <br /> ❑ Reco Ids provided by St rt-PPR Complete.starfN .Oei bU(n uA CIOt�15 t^K ! ILLI <br /> tt <br /> EHD"-06 Gl+iur'r1J 9u�.t Slt7(, eL �! (a0N'pt,yt/t't5 LTJy uWl.'Iu1t <br /> Received Time Oct. 28. 2015 8: 54AM No. 9891 (Alt;ovn75tein,L0000j-5)5,k (or WA75 <br /> td"ALuk coami32+t,++ltWflip L' elf A]u .N. PO4v-xLV--u�k560(KevN973 0.l(L�ctett1b56 Jwfa�il I�o MnwW. <br />