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0210512016 14:50 q(FAX) P.0011001 <br /> C([ FILE CGrY <br /> e "ft <br /> DATE RECEIVED EHD L00 NUMBER <br /> FEB 0 5 2016 OLrl � <br /> UNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> Em WIR0NM E NITALE1 E A M. 1668 Fast Hazelton Avenue, Stockton, CA 95205-6232 _. <br /> PERC.4GT EI Crj-%lephorte: (209)4663420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd .� <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: ,lennl%r Berjlkian F3US1NESS/AGENCY:Advanced GooEnvironmental <br /> ADDRESS: 837 Shaw Road CITY(STATEfZIFstockton,CA 95215 <br /> PHONE (1): 209-467-1006 PHONE (2): 2091183-3401 FAX CR E-MA[L:209-467-1118 <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 a " tment date and tirne to review the requested records. <br /> CHECK BOX TO EXPEDITE QUES 1 FEE(CASH CKECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAPS <br /> SIGNATURE OF APPLICANT DATE �— <br /> Electronle Information: p L-"e KIap e E~o4cription: <br /> FILE ADDRESS <br /> EHD USE ONLY <br /> Street-4 Street Name City <br /> 1 2420 South California Street - Stockton <br /> El Unit 1 <br /> 2. <br /> 2422 South California Street Stockton <br /> J• 2402 South California Street- '��� � � Stockton Ll Unit �Z <br /> 4• 2647 South California Street Stockton ❑Unit2H r `� <br /> S. <br /> 'Unit 3 <br /> B. Gj'Unit 3HM <br /> T El'Unit 4 <br /> E SITE MITIGATION <br /> 9. <br /> ®Unit <br /> Speclflc Date Range of information Requested: From to <br /> tNVIERONMENtAL HEALTH DEPARTMENT 51LES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MOTEUHOTEL ®SOLID WASTE FACILE�y(VE[OCiE <br /> ❑R OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑FOOD FACILITY <br /> ®Ur4DERGROUNDTANK(MONI717ORING/REMiOVA0 ®WASTE TIRE ❑DAIRY,POOLISPA <br /> ®ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTE4tATERTREATMEIdf PIAm r <br /> ®HAZARDDUS WASTE ❑MEDICAL WASTE FACILRY ❑PUWF-RTRUCK YAPWCHErvYCALTOILETS <br /> ®HAZARDOUS MATERIALS ❑TATrODIBODY PIERCING ❑LAND USE APPUCATJON SITES F° <br /> ❑TIERED PERMrrTED FACILITY Q COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFIC <br /> WELLAW SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY•FRIDAY 8:D0 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List j1p 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. Eax to(209)464-0138 or mall to the address Indicated above, Address <br /> ranges will not be accepted.Applications received after 3:00 pm twill be processed the next business day. <br /> 2. For assistance in idsnUfying 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 flies 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. Anpolntmento <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 /> Future file reviews by the same applicant may require a$130 deposit prior to ravlew. <br /> -BOXED AREA-EHDUS�(�Y"" <br /> Received TImeIFeb,. .5, !2016� '277P 11%o, 0446Stat"Nam: <br />