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DATENOV-15` 2007 3:43PM "danced Geo Environmental No. 0221HDLP•_.IJMSER <br /> SAN JOAQUIN COUNTY <br /> W ECCOV ED ENVIRONMENTAL HC I ATH DEPARTMENT, <br /> v 600 East Main Street, Stockton, CA 95202 <br /> 2007 Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sj ov.o /eIYS—� <br /> EWt}Wpite>=;IT HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> rn\Ilr CL <br /> /�1?_li@7Utfi0LrFi413� bCarranza BUSINESS/AGENCY: Advanced GeoEnviroamental <br /> ADDRESS: 837 Shaw Rd., Stockton, CA <br /> PHONE(1)7 209-467-1006 PHONE(2): 209-609-4067 FACSIMILE: 209-467-1118 <br /> TENTATIVE"APPOINTMENT DATE: ASAP Time: anytime <br /> (Please allow 10 business days from date of application submittal-`Tentative only-must be Confirmed) <br /> ,.HECK BOX TO EXPEDITE REQUEST-$95.00 FEE(CASH OR CHECK ONLY)•REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List❑ Map-Description: <br /> (� <br /> bE <br /> ,.__ FILEADDRESS EHD USE ONLY <br /> Street Name __ _ _ CI[y (� Unit 1 <br /> th Aurora Street Stockton (n0 �YJst Magnolia Street Stockton UST Oa . fir`sh Stanialaus Street Stockton oD th California Street Stockton UST IOZ� ZUnlifonia Street Stockton <br /> d 0 6, Stockton <br /> T ) UST 0.0 o <br /> -- - ❑ UntlS <br /> 9. <br /> �Unit6 <br /> Specific Date Range of Information Requested:From to 111114 <br /> ,r ENVIRONMENTAL HE ALT DEPARTMENT FILES <br /> tIlNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT }p$OLID WASTE rAGLITYNEHICLE <br /> Z„:)•TNER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY 0 WASTE TIRE <br /> Q DERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL n DAIRY <br /> HAiARDOUSWASrEGENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> Cl TIERED PERMITTED FACILITY 0 MOTEL/HOTEL O PUMPER TRUCK/YARD/CHEM TOILETS <br /> 0 TATTOO/BODY PIERCING 0 POOIISPA ❑ LAND USEAPPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELLANDSEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAYB:OO AM-5:00PM - EXCLUDINGHOUDAYS. <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(209)464-0138 or mail to the address indicated above Address <br /> ranges will notbe 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 notifythe applicantif 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 /> 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 same applicant may require a$95.00 deposit prior to review. <br /> EHD USE ONLY <br /> EHD 1606 u162W] <br />