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• • 11/11/2016 13:40 (FAX) P.0011001 <br /> r: Rt`:%.,iEQ .. <br /> l� <br /> DATE RECEIVED SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> NOV ' 20t ENVIRONMENTAL HEALTH DEPARTMENT 5� <br /> EfQVIRCf'�LL iAL F�11LTH 1868 East Hazelton Avenue, Stockton, CA 95205-8232 <br /> FtEf�AT IR Telephone:(209)488-3420 Fax:(209)464-0138 Web: v.org/ehdg5O <br /> RECORDS RELEASE APPLICATION <br /> APPLICANT: Erin Rottacker BUSINESS/AGENCY:Advanced GeoEnvironmental, Inc. <br /> ADDRESS: 837 Show Road CITY/STATE/ZIP: Stockton, CA 95215 <br /> PHONE(1): 209-167-1006 PHONE(2): FAX OR E-MAIL:erottacker(5advgeoenv.com <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 EXP�,,&&pp�i\\TE, REOUESryryyytt�$�1 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OFAPPLICANAn'A IYi[ /� _i DATE <br /> 1. List up to ten addressee III a space below. lett the type a ea from the flat below by checking the 611propriata <br /> box(es). At least one His type MUST be selected. Fax to(2091464-0133 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 flies will be held for a maximum of five buslnea i days for review. Appointments <br /> should be scheduled accordingly. <br /> 4. Any file not returned In the some condition as released will be reorgant"d 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:DOPM (EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map-Description: <br /> Specific Date Range of Information Requested: From to -�� <br /> ENVIRONMENTAL (� C-2 r j. <br /> HEALTH ILESRTMENT FILE ADDRESS EHD USE ONLY <br /> ®UNDERGROUND TANK(LIST) Street a Street Name City <br /> CLMNUP SITE(LOP) . I1, _ 7-7'76 <br /> CONORN R . <br /> ®OTHER CLEANUP SUE(NON-LOP) 1 2417 West Lane Stockton l.{ <br /> Ake ��IIB <br /> NArwRDOD9 WASTE <br /> ®TINNED FACILITY x 2413 West Lone N f Stockton D U)II <br /> ®ABDVEGAOLIND GGDND TANK e <br /> ®UST (MD UORING/REMOVAL _ Cl <br /> ® <br /> HAZARD( MATCRIALS 3 2801 West Lane Stockton <br /> ®SMLURELEASE RESM.B. / <br /> ❑SOLID WASTE CACILRY/VMIGLs WAT[e QNADTY <br /> 2244 West Lane Stockton <br /> ❑FOOD FACILITY , (�19 <br /> o PDot/SPA <br /> i _ i[MITIOATgN <br /> ❑DAIR ° 1233 East Ronald Street Stockton <br /> ❑LAND USE APPLICA70M SITES <br /> E]SEPTIC PUMPER TRUCK/ ❑Hawmo <br /> B <br /> YARD/CHEMICAL TOILETS <br /> ❑WAITEWATER TREATMCMT PUNT <br /> CUPA <br /> ❑HDUSINO ABATEMENT T If <br /> ❑MOTa1HOTEL <br /> ❑CHICKEN RANCH/DGG KENNEL CUPA.UST <br /> ❑ <br /> MMI WASTE RACILY B <br /> ❑TATTOOMQPY PIERCING <br /> ❑WA9IE TIRE ❑SOLID WAIUE <br /> B <br /> COMPLAINT <br /> OTHER(PLEASE SPECIFY): <br /> Q AGCONM,nG <br /> 10 <br /> '^aGXCG GROG-ENG USC ONLY'^ <br /> 4qe <br /> ( C <br /> ❑Records provided by Staff-PPR Complete. WAITNlm•: <br /> Received Time�Nov. 11. '2016' 1 : 20PNf No. 0342 <br />