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oATEMa r. 26.—W--$: 19AM Aduaoced GeoEnvironmenfal _ No, 4695 1vuMSER <br /> �.. SAN JOAQUIN_C S -- <br /> �V <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA <br /> PILAR 2 6 2009 Telephone: (209)468-3420 Fax; (209)464-0138 Web:ebeb:WwW.Swsjgov.org/ <br /> ENVIRUNMENT!1EALTH PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: A y colavita BUSINESSIAGENCY: Advanced Deosnvironmental <br /> ADDRESS: 837 Shaw Road, Stockton <br /> PHONEO): 467-1006 PHONE(2): 483-3401 FACSIMILE: 467-1118 <br /> TENTATIVE"APPOINTMENT DATE: ASAP Time: <br /> (Please allow 10 business days from data of appileatlon submittal-•Tentative only-must be Confirmed) <br /> 17 CHECK BOX TO EXPEDITE REQU OgfEE A OR CHECK ONLY)•REQUEST PROCESSED IN 7 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT <br /> _'0/cam DATE 3/26/9 <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street K Street Name City unit 1 <br /> 1. A9r% <br /> 445 North Stockton 5t. Stockton No d'�_ <br /> �V 2. 920 West Fremont St. Stockton 56W,N!)(,f�'r7 UnK2 <br /> YVI 3. 921 West Fremont St. _ Stockton y <br /> 4. 848 West Fremont St. Stockton 51 Z ,Nn W/ham Unita \\,Y <br /> ti Unit 4 <br /> 7. <br /> 8. nit s <br /> 9. <br /> 10, nit s <br /> Specific Date Range of Information Requested: From to <br /> f <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES f P <br /> ®UNDERGROUND TANK(USTI CLEANUP SITE(LOP) 0 HOUSING ABATEMENT M SOLID WASTE FACILITYNemICLE �1 ; <br /> ®OTNER CLEANUP SITE(NON•LOP) E3 FOOD FACILITY ®WASTE TIRE <br /> M UNDERGROUND TANK(MONITORINWREMOVALIK O DOD KENNEL ®DAIRY13 ,i %;✓ <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ®WASTEWATER TREATMENT PLANT <br /> ®TIERED PERMITTED FACILITYOI ❑MOTELIHOTEL ❑PUMPER TRUOKIYARDICHEM TOILETS <br /> O TATTOOIBOOYPIERCING Cl POOLISPA 10 LAND USE APPLICATION SITES <br /> ❑MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW• MONDAY-FRIDAY 8:00 AM4:OOPM • EXCLUDINO HOLIDAYS. <br /> 1. List up 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 file type MUST be selected. Fax to(2091484-0138 or mail to the address indicated above Address <br /> ranges will not be accepted—for additional assistance with file addresses,contact the EHD.Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant if any EHD riles 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 /> 3. A file that Is actively being worked on by EHD staff may not be Immediately available for review. A new application may be <br /> submitted when the file is available. <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$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> EMD 4849 W EB 8&2X)7 <br />