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tri 0411512014 16:15 (FAX) P.0011001 <br /> M DATE RECEIVED SAN JOAQUIN COUNTY C�a 41 EHD LOG NUMBER <br /> RE�CE ® p <br /> I @9 ED ENVIRONMENTAL HEALTH DEPARTMENT VY1 <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 w D <br /> 6 <br /> APR 15 2014Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Ally COlayita BUSINESS/AGENCY: Advanced GeOEnVlronmental <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP: Stockton/CA/95215 <br /> PHONE (1): 209-467-1006 PHONE(2): 209-483-3401 FACSIMILE: 209-467-1118 <br /> TENTATIVE*APPOINTMENT DATE: ASAP Time: <br /> (Please allow 10 business days from date of application submittal-Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CA§V OR HECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT a2' DATE <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE.ONLY <br /> street# Street Name city - CU i Unit1 <br /> a 1. 4343 East Fremont Street Stockton rt� H ` lily I IS e �P <br /> 2. 8MN1 P) t 1) SIO Unit2 1 <br /> 4 45 t Fremont Stockto <br /> 3 h <br /> 4. -r, 1171Unit3 <br /> 6. <br /> 6. 0Unit <br /> 7. 2 <br /> 8. Unit 5 <br /> 9. <br /> 10, i Unit S <br /> Specific Date Range of Information Requested: From all t0 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ❑X UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT OSOLIDWASTEFACILITYNEHICLE q Ml1 <br /> Q OTHER CLEANUP SITE(NDN-LOP) ❑FOOD FACILITY ❑x WASTE TIRE 1 CAS <br /> x❑UNDERGROUND TANK(MONITORINGIREMOVAL) [j DOG KENNEL ❑x DAIRY wu��•i`� <br /> 0 HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑x TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEm CAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOLISPA 0 LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑x COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 6:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the type(s)of flies from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to 209)464M 38 or mall to the addrese 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 files exist. An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The flies 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 reorganlzed by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. <br /> ' 0t% <6 �, '0 13 `)d ve ill ii ` 4)z 14 ' )p if7 =3 3 -. . � <br /> / pD�C1C1�R [�} �2 �C20 C3 S/1 L d�t�Cr] " v,Cz•°134 I re-�ilndl ,�oa t , Alor�t�e,-1 �c'I 'i P!" 1 <br /> '13 3 reryl� ;lgC:('fc. Siu'I'Ylwe Cc.fkic.vL9 `.3,4. F,^e4yU,_t J L(SI 1 S C•:' '-� �'� F('L'il LI <br /> T IlC1-d�(Qi-{'rvM[.re)' nn:_cLc( Vino 4aJ;;l;nt i-e .i Pow f5kkLMaric. Puri« ts. 4qgTFey)lonfi. <br />