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FI'omK�gL�ebl�alP®x�(E070tQ 461 To: 2094840133@rcfax.cor Fax: (209)464-0138 Page 2 of 2 07128120179:23 AM <br /> DATE RECEIVED pV■ SAN JOAQUIN COUNTY fl ZINE Z EHD LOG NUMBER <br /> JUL,F� 9 /'� <br /> fB ENVIRONMENTAL HEALTH DEPARTMENT � <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> RNIVIliloNjilliNTAL FttaALt"H Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> PEPWITMF M4CES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Diane Becker BUSINESSIAGENCY:Advanced GeoEnvironmental, Inc. <br /> ADDRESS: 837 Shaw Road CITY/STATEIZIP:Stockton, CA 95215 <br /> PHONE(1): 209-467-1006 PHONE(2): FAX OR E-MAIL: <br /> Please allow 10 business days fr m date of application submittal for the records to be available. <br /> Staff will contact yo) to arrang an appointment date and time to review the requested records. <br /> t <br /> ❑ CHECK BOX TO EXPEDITE UEST-$1 9 FEE(C�CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 07/28/2017 <br /> 1. List uo to ten addresses in Me space b4low. 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 3:00 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 It 0) <br /> days after receipt of application. The flies 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 /> �� <br /> Future fie 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-5:00PM(EXCLUDING HOLIDAYS) <br /> Electronic information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From 1940 to present <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS EHD USE ONLYFILES <br /> x❑UNDERGROUND TANK(UST) Street# Street Name City <br /> CLEANUP SITE(LOP) 0 CONSUMER <br /> ©OMEN CLEANUP SUE(NON-LOP) ' 2315 N. California St. Stockton Lor <br /> �LtV <br /> ©HAZARDOUS WASTE C]DAIRY <br /> ®TIERED PERMmm FACILRY 2 <br /> ©ABOVEGROUND TANK <br /> x❑UST (MONITOHINGI REMOVAL) n PWs <br /> X HAZARDOUS MATERIALS S <br /> O SHLUREIEASE RESPONSE Q 2 <br /> SOLID wAs1 E FACILITY I VEHICLE. 4 vIJ 1� WATER QuamY <br /> ❑FOOD FACILITY V 1 I <br /> I]POOL I SPA Sine MRIWnoN <br /> ❑DAIRY 0 <br /> i]LAND USE APPLICATION SUM <br /> HlnlaiNc <br /> F1SEPTIC PUMPER TRUCK/ <br /> 6 <br /> YARD/CHEMICAL TOILETS <br /> WASTEWATER TREATLIENT PLANT UPA <br /> n HOUSINGAMTEMENT r <br /> ❑MCTEIIHOTEL <br /> Ile- <br /> []CHICKEN RANCH/DOG KENNEL CUPA-UST <br /> ❑MFOICAL WASTE FACILITY B <br /> ❑TATTOOIBODY PIERCING <br /> Souo WASTE <br /> I]WARE TIRE <br /> 9 <br /> x❑COMPLAINT <br /> ❑01 HER(PLEASE SPECIFY): �p¢oUNnno <br /> 10 <br /> '—BOXED AREA-EHD USE ONLY"' <br /> ❑ Records provided by Staff-PPR Complete. staff Name: <br /> EHD 48-06 <br /> Received Time Ju1. 28. 2017 9: 18AM No, 1984 <br />