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0 <br /> EHD LOG NUMBER <br /> len 'Ar—CFEIVED SAN JOAQUIN COUNTY 'Nod <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> FEB 10 2015 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464.0138 Web:www,sjgov.org/ehd �n <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Yukarl Hlrayama BUSINESS/AGENCY:Advanced GeoEnylronmental <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP: Stockton/CA/95215 <br /> PHONE(1): 818-486-2150 PHONE (2):209-623-7200 FACSIMILE: 209-467-1118 <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Plaase allow 10 business days from data of application submittal--Tanfafiva only-muat be eomiinned) - <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT % DATE 2/10/2015 <br /> Electronic Informatlon: ❑ Llst❑ Map—Descflptlgn: <br /> MILE ADDRESS END USE ONLY <br /> Street# - Street Name City UO -11-unitI <br /> 1• 1413 Bourbon Street Stockton <br /> 2. 3755 West Lane Stockton RST"c I �` --6nit2 79111, <br /> 3. 3805 West Lane Stockton <br /> 4. f^ ptrita <br /> 6. <br /> 6. .p u mt 4 <br /> 7. (e <br /> rI-t <br /> s. 10,�lg <br /> El Unit 5 <br /> Specific Data Range of Informatlon ROquastad: From all - to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> O UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑x SOLID WASTE FACILI YNEHICLE <br /> El OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY 0 WASTE TIRE <br /> x❑UNDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL ❑x DAIRY <br /> X❑HAZARODUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> X❑TIERED PERMITTED FACILITY ❑MOTEL/HOTEL - ❑PUMPER TRUCK/YARD/CHEMICAL TOILETS <br /> ❑TATTOO/BODY PIERCING ❑POOLISPA 0 LAND USE APPDCATION SITES <br /> ❑ MEDICAL WASTE FACILITY 0 COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-S:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list 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-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 files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that i3 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 reorganized by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$/�1,,2�5 deposit prior to review. <br /> aV„IeJ• W InST ti f rh r 31 51S Wes{ 1. . <br /> Rece-ived Time Feb. 10. 2015 11 :45AM No. 8087 Willi <br />