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ao _� <br /> 050'312016 11:-. q d;; (FAX) P.0011001 <br /> e� V - • • <br /> E� DATE REPglyED, ; SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> MAY. ENVIRONMENTAL HEALTH DEPARTMENT 45 <br /> 1868 East Hazelton Avenue,Stockton,CA 95205-6232 <br /> E!NM§b MENTAL HEALTHTelephone: (209)4683420 Fax:(209)464-0138 Web:vnvw.sjgov.arg/ehd <br /> P ETrSE€MGE,9i " PUBLIC RECORDS RI=LEASI=APPLICATION <br /> APPLICANT: Rene Toth BUSWESSrAGENOY:Adyanced GeoEnvironmental <br /> ADDRESS: �f 37 Shaw Road CITY/STATE/ZIP:Stockton Californla 95215 <br /> PHONE(1): (209) 467-1006 PHONE(2): FAX OR E-MAIL: RToth@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 reviewthe requested records, <br /> El CHECK BOX TO EXPEDITE REQUEST-$130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 5/13/2016 <br /> 1. List up to ten addresses Ir the pe a =w. Select the pe{ o ea from the list below by checking the appropriate <br /> box(es). At least one file type a UST be selected. Fax to(209)464-0136 or mall to the address Indleat d above Address <br /> ranges will not be accepted.Appllcatlons 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 END flies exist. An appointment for review will be confirmed approArnately ten(10) <br /> days after receipt of application. The flies will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> e. Any file not returned in the same condition as released will be reorganized by END staff at the expense of the applicant. <br /> Future file reviews by the Same applicant may require a$130 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM•8:00PId(EXCLUDING HOLIDAYS) <br /> Electronic information: ❑ List❑ Map—Description: <br /> Specific Date Range of Informdtlon Requested: From to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES EHD USE ONLY <br /> ®UNDERORDUND TANK(UST) Street# Street Name City <br /> CLEANUP SITE(LOP) <br /> OTHEA CLEANUP SITE(NON-LOP T 2f326—' Teepee Drivep.f f Stockton N i <br /> ®HAZAROOVaMITTED WASTE �] D4�' <br /> RI TIERED PERFADILI 2 2-s135 Teepee Drive N Stockton <br /> Q ABOVEGROUND TANK I 2 <br /> g' UST (MONROMNOIREMOVAL) ❑PWS <br /> ®HALIRDDUB MATEWALe S <br /> ®SPILURELEASE RESPONSE <br /> ®SOLD WASTE PRCILITYI VEHICLEa wcT QUALITY <br /> FOOD FACILITY <br /> i <br /> FIPOOL/SPA [Jf SITE MITDATKN <br /> OAIFI 6 } <br /> ®LAND USE APPLICATION SITES <br /> SEPTIC PUMPER TRUCK I , Q Houma <br /> YARD I CHEMICAL TOILETS <br /> ®WASTEWATER TREATMENT PUNT ffCUPA <br /> HDUBIND AEATEMENT r <br /> MO WHOTEL <br /> d CHICKEN RANCH/DOG KENNEL 0 COPA-NAL-MAT <br /> MEDICAL WASTE FACILITY D <br /> TATTOOIaODY PIERCING / <br /> �9otm W.Prl <br /> ®WASTE TIRE y <br /> ®COMPU.IY.T <br /> OTHER(PLEAUE,SPECIFY): ACODNIINO <br /> 10 <br /> (. "'BOXED AREA-EHD USE ONLY't <br /> 5-2 l <br /> 2 CD <br /> r o rZ - <br /> n Ra—ria nrrwirlarl 45j,Rtaff_PPR Cr ' to a Staff ams: <br /> Received Time=May. 11 -2016=11 : 21AMF'No. 0199 <br /> cw Newv <br />