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aIPF 1',!0312014 11:40 ) <br /> P.000111 <br /> 0001 <br /> CD <br /> o ]4TH RECEIVED QD <br /> U \ , 'l�" SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> {-HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> 1`�4r p�2if 1TGlephone: (209)468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> t <br /> ENVInPMIjTI'r17t,LHEAL1'I; PUBLIC RECORDS RELEASE APPLICATION <br /> pFalalTr�FFtyIC_S <br /> APPLICANT:Jennifer Beriikian ISUSINESS/ACENcY:Advanced GeoEnvlronmental <br /> ADDRESS: 837 North Shaw Road CITY/STATEIZIP: Stockton, CA <br /> PHONE (1): (209)467-1006 PHONE (2):(209)483-3401 FACSIMILE: (209)467-1118 <br /> TENTATIVE*APPOINTMENT DATE: ASAP Time: <br /> (Pisses allow 10 business days from date of application submittal-`PanPaflvs on y-musf be confirmed) <br /> ❑CHECK BOX TO EXPEDITE 0 -S1. - E ASH OR CHECK ONLY)-REQUEST PROCESSED 114 3 BU (NESS DAYS <br /> SIGNATURE OF APPLICA T DATE O L <br /> Electronic Information: ❑ Llat❑ Mao- Dcascription: <br /> FILE ADDRESS EHD USE ONLY <br /> Otroat d Street Name city Unit 1 <br /> 1. 1201 Gertrude Avenue Q ) Stockon <br /> 2. 1203 Gertrude Avenue Stockton 0( <br /> 4 3. 1275 Gertrude Avenue Stockton I ' c �' <br /> 4 4. 4343 Fremont Street Stockton - � <br /> 40cm 'ek�� Unit3 <br /> 6. 1133 Shaw Road r 1% Stockton ,,)Db h O SP <br /> s, u it4 <br /> 7. <br /> 9. Unit 6 <br /> 9. <br /> Specific Data Pangs of InformuBlon Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> OUNDERGROUNDTANK(UST)CLEANUPSIrE(LOP) ❑HOUSING ASATENIENT ®SOLID WASTE FACILRYNEHICLE 3�1� <br /> ❑x OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILTTY WASTE TIRE <br /> Q UNDERGROUNDTANK(MONITORING/REMOVAL) ®DOG KENNEL ®DAIRY pA L^ <br /> Q HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ®WASTENATER TREATMENT PLANT <br /> ®TIERED PERMrrIED FACILITY ❑MOTEUHDTEL ❑PUMPER TRUCKIYARDICHEMICALTOILETS <br /> ❑TATFOD/BODY PIERCING ❑POOUSPA LAND USE APPUCATIDN SITES <br /> ❑ MEDICAL WASTE FACILITY ®CINuPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-S:OOPM(EXCLUDING HOLIDAYS) <br /> I. Llai uo Lo ten addrasaas In the apace above. Select the type(s)of Man from the IIA above by checking the appropriate <br /> box(es). At least one file type MUST be agtccted. Fax Rp 12091466.0939 or mall to the eddress lragated above. Addlass <br /> ranges will not be accepted-for additional aeeistaneo vAth fileaddresses,contact the EHD. Applications received after <br /> 3:00 pm will be procassed lite next business day. <br /> 2. The EHD will notify the applicant If any Elio Giles exist. An appointment for review vAl l be confirmed approximately ten(10) <br /> days after receipt of application. The flle--will be hold for a.maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that Ie acUvsiy being worked on by EHD ateff 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 condifion as released will be reorganized by EHD staff at the expense of the appticanL <br /> Future file reviawa by the same applicant may require a$126 deposit pilot to review. <br /> 1 •. t P - I�riaon�# � XSi ��11�7a C4343F . Pte _ ;1l l.usTF,/�.. <br /> D0 ZSSS: i G w a sra8 I • d1 iiw le of 53y3 re to Gc� pravldd P3sp�) <br /> eF rpTSio(ofor 1Z75CjcrhvcL PrLy'et¢�f ioLt� rota ,w /o u/cr- , $ �, ia+ Fvr iwf Gu�frticl: <br /> r k !27 er d^edrlJf , ProrldgA a)&)dM-for439 re j sntu fd �iin)t <br /> HD As.o6� <br /> s1 f�ll4i nch�e;JorHlern o.;nla,ner B clFtc xaihw`ecc+ata;ne <br /> Received Time Nov, 3. 2014 11 , 22AM No- 7461 <br />