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03/08/2005 14:49 2094671118 AGE STOCKTON16 PAGE 01/0 <br /> ffi <br /> DAcmy' -En <br /> nDLOG NUMBER <br /> VE" SAN JOA`.CITIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT W0s- t1 6U <br /> MAR 8 - 7005 304.E Weber Ave 3rd Floor Stockton, CA 95205 PRD PS " LQaSC <br /> (209)468-3420 Fax: (209)464-0]38 Web: www.co.san-joaquin.ca.us/chd Ca`l t� 8 C)U-)n <br /> ENVIRONMENT HEALTH <br /> PERMIUSFUGES PUBLIC RECORDS RELEASE APPLICATION ed�� <br /> APPLICANT: Suzanne Henderson BUSINESS/AGENCY: Advanced GeoEnvironmantal, Inc. <br /> E <br /> ADDRESS: 837 Shaw Road Stockton CA 95215 <br /> PHONE: 209-467-1006 FACSIMILE: 209487-1 1 1 8 <br /> TENTATIVE*APPOINTMENT DATE: 14 March 2005 10:00amPd"'Imn <br /> (Plaaaa allow 10 buslneae days from date of appucadon aubmtttal) W_2�9 i-�'�A <br /> ® CHECK BOX TO EXPEDITE REQU -59 .00 FEE-REQUEST P O ESSED I 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE OC �*rC� J-00.5 <br /> Department Use Only <br /> FILE ADDRESS UNIT <br /> N lF 1, 6v„t 9898 South Jack Tone Road c Stockton <br /> 2. st,,a 9970 South Jack Tone Road c Stockton ❑ Unit 1 <br /> 3. Slrea 21010 South Manteca Road c, <br /> ,y Manteca, Evans Trucking 2 <br /> w/F 4. sten 21330 South Manteca Road Unt 2 � <br /> c Manteca �,�(�,{�+ <br /> s. s�at 21434 South Manteca Road o Manteca �� Ii nit 3 -3 <br /> a, s:.e, 21710 South Manteca Road V <br /> Cu Manteca <br /> 7. sleet 21800 South Manteca Road cat Manteca 1J?�UniitIV) e srmi 21908 South Manteca Road 4 <br /> u s r Manteca <br /> �/ 2494 East Fremont Street o, Stockton <br /> 10. street Balmat&Co","Sedan Avenue" ❑ Unit 5 <br /> Manteca(only SLIC address <br /> Orphan <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES bec7 amrtss <br /> N UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOUD WASTE FACILITY <br /> X OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOUD WASTE VEHICLE <br /> M UNDERGROUND TANK(MONITORINWREMOVAL) ❑ DOG KENNEL )Q DAIRY <br /> P4 HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELMOTEL ❑ PUMPER TRUCK/YARD/CHEM TOILETS <br /> El TATTOO/BODY PIERCING ❑ POOL/SPA Q 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 flies from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected, Fax to 209 464-0138 or mail to th <br /> address indicated 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 EHD 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 EIIAD 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 /> S• *TENTATIVE appointment dates must be confirmed with EHD 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 /> etio�e-oa•oaa <br /> LYereraooa <br />