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RECEIVED <br /> o AN _%J OAA U IN MAR 2 3 2018 Environmental Health Department <br /> - - COUNTY --_ PUBLIC RECORDS RELEASE APPLICATION <br /> ENVIRONMENTPI HE" <br /> PERMIT/SE 0(27(4 <br /> EHD LOG NUiVIBER. <br /> V�32 <br /> APPLICANT: P.ebeccaNatal BUSINESSIAGENCY:Advanced GeeEnvironmental,tnc. <br /> ADDRESS: 837 Shaw Road CITY/STATEIZIP:Stockton,California 95215 <br /> PHONE (1): 209-467-1006 PHONE(2):209-623-7200 FAX OR E-MAIL: rnatal@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 arrang n ppoin dat a time to review the requested records. <br /> SIGNATURE OF APPLICANT DATE 312312018 <br /> 1. List up to ten addresses in the space below. Address ran es W L NOT be accepted. Select the type(s)of files from the <br /> list below by checking the appropriate box(es). At feast one fil type MUST be selected. Fax to (209)464-0138, mail to the <br /> address indicated below, or email to info s'cehd.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; MONDAY31 <br /> -FRIDAY 8:00 AM-S:OOPM{EXCLUDING HOLIDAYS) " i <br /> Electronic Information: 0 List ❑ Map— Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ���IES <br /> HEALTH LRIENT HD USE ONLY <br /> FILES ES (Specific addresses only,address ranges will not be accepted) <br /> ®Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) <br /> Q Olher Cleanup Site(Nan-LOP) <br /> 1 3805 West Lane Stockton �;`���,� repo C-1-n <br /> ®Hazardous Waste `s <br /> i55/3/L El DAIRY <br /> Q Tiered Permitted Facility 2 621 N Broadway Ave Stockton , rV� <br /> ®Aboveground Tank <br /> UST (Monitoring!Removal) / // ''��--��, �PWS <br /> 0 Hazardous Matedals 3 � ( J0CJG U i C( <br /> ®Spill!Release Response 7,24 1 / <br /> WArEn Qunury <br /> Solid waste Facility/Vehicle 4 <br /> ❑Food Facility <br /> Pool 1 Spa <br /> �] Dairy 5 <br /> FX] Land Use Application Sites <br /> F]Septic Pum par Truck 1 2E]HousiNG <br /> 6 <br /> Yard 1 Chemical Toilets <br /> Wastewater Treatment Plant COPA <br /> ❑Housing Abatement 7 AST!HM 1 HW <br /> El Mote[lHctel <br /> F]Chicken Ranch/Dog Kennel N&PA <br /> 8[�Medical Waste Facility LIST <br /> ®TattoolBody Piercing <br /> SOLID WAS4E <br /> FRI Waste Tire 9 <br /> Pq Complaint <br /> T7 Other(Please Specify): El AccourmNc <br /> 10 <br /> t— ***BOXED AREA-EHD USE ONLY <br /> [FMe -' 0( n <br /> Records provided by Staff-PPR Complete. staff Name: HHD 48.06 <br /> 11168 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 f F 209 464-0138 1 www.sjcehd.com <br />