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r� IU14014U,0 Uavz (rAX) H.UUIIUU1 <br /> Ips <br /> IseRKEVED • EHD LOG NUMBER <br /> law SAN JOAQUIN COUNTY <br /> OCT 28 2015 ENVIRONMENTAL HEALTH DEPARTMENT Ffj 'A 07 <br /> S 1868 East Hazelton Avenue, Stockton, CA 95205.6232 Qti <br /> ENVIRONMENTALHEAL79'ephone: (209)466-3420 Fax: (209)464-0138 Web: www.slgov.org/ehd <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Jennifer Berjiklan BUSINESSIAGENCYAdvanced GeoEnvironmentai <br /> ADDRESS: 837 Shaw Road CITYISTATEIZIP: Stockton,CA 95215 <br /> PHONE(1): 209487-1006 PHONE(2): 209483-3401 FACSIMILE:209-467-1118 <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> ❑ CHECK BOX TO EXPEDITE REQUE CASH OR CHECK ONLY)-REQUEST PROCESSED IN$ INESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> ElectronlcInformation; E] List CTMap-Description: <br /> FILE ADDRESS <br /> )VLStreet S Street Name City EHD USE ONLY <br /> 1. 825 Navy Drive Stockton -, <br /> 2. 1137 South Stockton Street Stockton �[� S <br /> nit 1 <br /> 3, 1240 Navy Ddva Stockton L�e✓� �i ff 4Y f'p nt2 <br /> wo'l 40 <br /> 4. 1145 West Charter Way Stockton �I,e�,-Co/ u `��H""' <br /> S. 939 West Charter Wsy Stockton nr plt�- I Cij <br /> ( - 6. 6 5"( -L W v /��I�ZYI �'S nil3 <br /> 7. tT� 9nit4 <br /> a• II' IEV85TE MITIGATION <br /> 9. <br /> 10. <br /> nit 6 <br /> Specific Data Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑v SOLID WASTE FACILIrYNEHiCLE <br /> THER CLEANUP SITE(NON-LOP) ❑HOUsi"ABATEMENT Q*ASTE TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> eOVEGROUND TANK ❑CHICKEN RANCHI DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> Ly't1A2ARDOUS WASTEIHA2ARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCK(YARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOUSPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING Q CONPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELLAND S EPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1, hist up to ten addresses In the space above. Select the typs(s)of files from the flat above by checking the appropriate <br /> box(es), At least one file type MUST be selected, Fax to(209)464.0138 or mall to the address Indicated above, Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance In Identifying the nature and content of EHD records,please contact EHD at the number noted above, <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 live 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$130 deposit prior to review. "'BOXED AREA-EHD U26 ONLY"' <br /> qI).ek 0'r-v" l V'15+ 1140 /1r Ill 5{/'a �t ,Q 114 Va . el(A5T 1) A <br /> 1(4 "M W ,,,(A. soled I r� fi hU t3a�+ Ilvo IAW f. Il P t to, IIKS <br /> Lt,WtT k-U CD. C ow I 1�5 t4 In k ST Ile{.oryet- <br /> C(7 CO z 'h ASIAIeCjr IiLv AJ4v CoLt;euls cb, 16 t <br /> ❑ Records provided by Staff-PPR Complete.staff Nam.: Cp,m 6N(v un (000'15 'OA <br /> EHo m-a° C-Lw 1r �-4b, )Uylt 5(OL l✓y for GnwCli,rtnty C•drtuQ7l 7u{t <br /> Received Time Ocf, 28, 2015 8: 54AM No. 9891 0(. '0'n15, AJLW(.,0j}�y (nerLl''tSCt%Y ei-t �,,� <br /> co-Oak coa*38��f mvtktf lin 4.. 9).,; uuw AP, paa kk(0.4kkks 60v.X74`173&. L Lc9u00&z;& t1A I64rW 11MO Nwn Or. <br />