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03/08/2005 14:49 2094671118 AGE STOCKTON PAGE 01/0 <br /> DATE qq'9E, <br /> LOG NUMBER <br /> D , SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT YY)OS'tt 6 _ <br /> & <br /> 304 E Weber.Ave 3rd Floor Stockton, CA 95205 IP 0-6 PS : u <br /> ('AA`s 8 — 70 5 (209)468-3420 Fax: (209)464-0138 Web: w-w-,v.co.san joaquin.ca.us/ehd kill l� 8OL.t)n <br /> ENVIRONMENT HEALTH1 <br /> PEWIT1SESVtCFS PUBLIC RECORDS RELEASE APPLICATION �17�� <br /> APPLICANT: Suzanne Henderson RUSINESS/AGENCY: Advanced GaoEnvironmenial, Inc. <br /> ADDRESS: 837 Shaw Road Stockton,CA 95215 <br /> PHONE: 208-487-1008 FACSIMILE: 209-467-1118 <br /> TENTATIVE*APPOINTMENT DATE: 14 March 2005 TIm0: 10:00am <br /> (Plaasa allow 10 bualneas days from pate of application submittal) <br /> El CHECK BOX TO EXPEDITE REQUE -Ea00 FEE-REQUEST P O ESSED I 3 BUSINESS DAYS �yJ� / F <br /> SIGNATURE OF APPLICANT'Y, DATE a9 "y rcki joa <br /> Department Use Only <br /> FILE ADDRESS UNIT <br /> stmt 9898 South Jack Tone Road o,, Stockton <br /> �"�lLm usTs roe <br /> sll 9970 South Jack Tone Road ci Stockton ❑ Unit 1 <br /> +' <br /> '.'s 3. Stroot 21010 South Manteca Road ce'y Manteca, Evans Trucking 6:Unit 2 <br /> NI F +. sheat 21338 South Manteca Road c Manteca ��(��uJ <br /> N A 5 shat 21434 South Manteca Road c Manteca X13 3 C i/ t <br /> Unit 3 <br /> e. s��, 21710 South Manteca Road c„ Manteca U <br /> rvl+' sa et 21800 South Manteca Road aj Manteca Unit 4 <br /> N1F e sem. 21906 South Manteca Road G Manteca <br /> 2494 East Fremont Street c1ly Stockton <br /> Lia street 'Balmat&Co","Sedan Avenue" 171 Unit 5 <br /> c Manteca(only SLIC address <br /> Orphan S0e) <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES d0.c7 Qmf ess <br /> N UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> DQ OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOUD WASTE VEHICLE o <br /> 7) UNDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL )( DAIRY <br /> PQ HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTEUHOTEL r7 PUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑ TATTOO/BODY PIERCING ❑ POOL/SPA 0 LAND USE APPLICATION SITES <br /> ❑ MEDICAL,WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. F_ax_to(209)464-0138 or mail to the <br /> addressiRdicated above. <br /> 2. EHD will notify the applicant If any EHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten(10)days after receipt of application. The files <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by END staff may not be immediately available for review. A new <br /> application may be 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 <br /> of the applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review, <br /> 5. *TENTATIVE appointment dates must be confirmed with EHO staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> EHP ISA2-0OA <br /> erenooa <br />