Laserfiche WebLink
/16 16;08 ALL`WE/ST ENVIRONMENTAL (415)391-2008 Page 1 <br /> Ili CI i� ED <br /> ■� DATE RECEIVED <br /> ■ SEP Z 8 2016 SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> ENVIRO<vfidENTALHEAUH 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> PRONM <br /> ENVIRONMENTAL <br /> Telephone: (209)468-3420 Fax: (209)464-0133 Web:vrvrv,sjaov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Affivest FnvironmentallnC. _BUSINESSIAGENCY: Environ.mentalConsultant <br /> ADDRESS: 2141 AliSSO' n Street, Ste 100 CITY/STATE/Zi P: San Francisco, Cit <br /> PHONE(1): 415-39.1-25.10 — - 94110 <br /> _ PHONE(2): 3��0-322 g23 _FAX OR E-MAIL: sorraaCFvestl.com. <br /> Please allovr 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 -S13 fE ASH OR CHECK ONLY)-REQUEST PROCESSED IN 31BUSIVESS DAYS <br /> SIGNATURE OF APPLICANT DATE )� <br /> 1. List ua to ten addresses in the space ow, Se ct the type(s)of files from the list below by checks g 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.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 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 some applicant may require a$139 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 3:00 AM-5:DOPM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List ❑ Map– Description: <br /> Specific Date Range of Information Requested: From _ _ to <br /> MENTAL <br /> DEPARTMENT 7ADDRESS <br /> FILES EHD USE ONLY <br /> UNOErtGROUND TANK(UST) Street CltyCLEANUP SITE(LOP)0OTNFRCLEANUPSIT'E(NON•I.op) 1488 TVStockton0 HAZAHUOUSWA&fE®TIERUD PEMITTELI FACILITY A.rRt <br /> 1505 TiStockton I►1'"1��-�f /rte}�J�/���y//� <br /> ACiOVEChOUND TANK �►f ""1 r1 i� `'�aV• '• <br /> ®LIST(MONITORING/REMOVAL) - <br /> ❑PWg <br /> ®HAZARDOUS MATERIALS 1604 Willie 1'ewis Dr StQCI2t011 <br /> ®SPILL URM.EASE RmPONSF � 010,61! <br /> ®SOLID WAsrE FACILITY VEHICLE 1625 Tillie Lewis Dr WATER QUALITY <br /> FOOD FACILITY V J Stockton. 1 ' � C <br /> POOL/SPA <br /> ®DAIRY <br /> sI*F Mm.Garl'.,, <br /> LAND USE APPLICATToN SITES (,)—I- I <br /> SEPTIC PUMPER TRUCK/ _r'( '❑ Ve1t,� V <br /> YARD/CHEMICAL TOILETS 8 i <br /> WASTEWATER TREATMENT PLANT <br /> H(,WSw s ABATEMENT 7 <br /> CUpA <br /> Mo-ra./HOTEL i <br /> CHICKEN Ra>IGH/DOG KENNEL <br /> [)Meuu:nL WntirE Faculry a <br /> CUPA.UST' <br /> TAT 001BLoY PIFP..CING <br /> WASTE TIRE i 9 I Solo Wawa <br /> ©COMPLAINT <br /> OTHER(PLEASE SPECIFY): - <br /> -.....___ <br /> 'IU i AcL+,-j r,_ <br /> � I I <br /> F <br /> "'E1l7XED AREA-EHD USE ONLY"' <br /> D <br /> ❑ Records provided by Staff-PPR Complete, staftNamc: <br /> Received 71me"SeP. 27. -2016- 3 ; 16PNFN0 <br /> , 0061 <br />