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�IVED61 To: <br />Fax: (209) 464-0138 <br />Page 1 of 1 01/3120174:08 PM <br />SAN JOAWUIN COUNTY EHD LOG NUMBER <br />FEB 6�Q�% ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />ALPIEWN Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />aF�1AIrr�FSAac��t <br />P� NTMACER PUBLIC RECORDS RELEASE APPLICATION <br />95,5qq <br />-'APPLICANT: Jackie Hyman BUSINESS/AGENCY: Advanced GeoEnvironmental, Inc. <br />ADDRESS: 3335 E. Miraloma Ave. #142 CITY/STATE/ZIP: Anaheim CA 92806 <br />PHONE (1): 800-511-93nn PHONE (2): FAX OR E-MAIL: I rnan advgeo nv om <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 ar^,� J,IFqT- $139 FEE (CASH OR CHECK ONLY) -REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT (CJ�.(�,�"_- DATE 31 January 2017 <br />1. List up to ten addresses In the space below. Select the type(s) of files from the list below 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 not be accepted. Applications received after 3:0`0 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 five 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 $139 deposit prior to review. <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM -5:0013M (EXCLUDING HOLIDAYS) <br />Electronic Information: ❑ List ❑ Map — Description: <br />Specific Date Range of Information Requested: From to <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />FILES <br />FILE ADDRESS <br />&• 1 2-q-1 <br />EHD USE ONLY <br />® UNDERGROUND TANK (UST) <br />te. stall Marne: <br />Street <br />Street Name <br />City <br />CLEANUP SIM (LOP) <br />OTHER CLEANUP SI IN ON -LOP) <br />® HAZARDOUS WASTE <br />TIMED FERMFACILITY <br />2648 <br />2648 <br />Teepee Drive <br />Stockton <br />U5i� P�CONSUMEB <br />1 <br />/5 <br />2 <br />2735 <br />Teepee Drive <br />Stockton <br />T <br />� 7.9W 1 <br />(/a /Y <br />0013 <br />LJ DNFERMI® <br />® ABOVEGROUND TANK <br />PWS <br />®UST (MONITORING/REMOVAL) <br />® HAZARDOUS MATvunta <br />3 <br />M SHLURELEASE RESPONSE <br />4 <br />WATER DO-- <br />F1 SOLID WAST[ FACIUW / VEHICLE <br />❑ FDOG FAalm <br />❑ P COL. / SPA <br />SRE MI IMMON <br />❑ DARY <br />5 <br />® LAND USE APPLICATION SITES <br />6 <br />HOVBING <br />E] SEPTIC PUMPER TRUCK / <br />YARD / CHEMICAL TOILETS <br />WASTEWATER TREATMENT PLANT <br />HOUSING ABATEMENT <br />T <br />CUPA <br />MOMLIHOTGL <br />❑ C HICKEN RANCH / DOG KENNEL <br />CUPA - UST <br />❑ MEDICAL WASTE FACILITY <br />e <br />❑ TATTOO/BODY PIERCING <br />9 <br />❑ SOLID WASTE <br />WASIS TIRE <br />❑ COMPLAINT <br />r-1 OTHER(PLEAEE SPECIFO: <br />Accouxnx0 <br />10 <br />`BOXED AREA - EHD USE ONLY - <br />neCeIVea I lme jan, Ji, LUI( 4 V7rlh luo. 01)1 <br />IN <br />0 Records provided by Staff -PPR <br />te. stall Marne: <br />neCeIVea I lme jan, Ji, LUI( 4 V7rlh luo. 01)1 <br />IN <br />