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SAN JOAQUINR CEIV . <br /> nvlronmental Health Department <br /> 1.■=� s.u. <br /> —COUNTY— APR 6 9 206 PUBLIC RECORDS RELEASE APPLICATION <br /> • Gireatnes, greris he � <br /> EIdVIR011PJIEN gr7�g <br /> LfPMAIL <br /> EKED LOG NUMBER: <br /> APPLICANT: Rebecca Natal BUSINESSIAGENCY:Advanced GeoEnvironmental,Inc. <br /> ADDRESS: 637,9haw Road CITYISTATEIZIP.stockton l CA/95242 <br /> PHONE (1): 209-467-1006 PHONE(2):209-623-7200 FAX OR E-MAIL: mata10uadvgeoenv.wrn <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 appointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT DATE 4-g-zols <br /> 1. List up to ten addresses in the space below. Address ranges WILL NOT be accepted. Select the type(s) of files from the <br /> list below by checking the appropriate box(es). At least one file type MUST be selected. Fax to(209)464-4138, mail to the <br /> address indicated below, or email to infoO)5jcehd.com. Applications received after 3:00 pm will be processed the next <br /> business day. <br /> 2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted below. <br /> 3. 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 /> 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$152 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM•5:OOPM (EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map-Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT ( P y 9 accepted) EHD USE ONLY <br /> FILES (Specific addresses and address ranges will not be acce ted <br /> IX Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LDP) i{M ❑CONSUMER <br /> Q Other Cleanup site(Non-LOP) 1 3001 Navone Rd Stockton <br /> • Q Hazardous Waste Fit~ ❑DAIRY <br /> Q Tiered Permitted Facility 2 2908 Bozzano Rd Stockton <br /> Q Aboveground Tank <br /> rX UST (Monitaring!Removal) <br /> Hazardous Materials ' 2881 Navone Rd Stockton � PWS <br /> Q SpA 1 Release Response a' <br /> ��� II I V 1 ER QUALITY <br /> Solid waste Facility lVehicle 4 3301 Navone Rd Stockton 1 <br /> Food Facility <br /> Pool!spa 5 ncAnoN <br /> Dairy 5 <br /> 0 Land Use Application Sites <br /> p HOUSING <br /> Septic Pumper Truck 1 6 <br /> Yard I Chemical Toilets <br /> Q wastewater Treatment Plant CUPA <br /> Housing Abatement 7 AST!HM!HW <br /> MotellHotel <br /> Chicken Ranch!bog Kennel CUPA <br /> a UST <br /> Medical Waste Facility <br /> E]Tattoo/Body Piercing SOLID WASTE <br /> Q Waste Tire 9 <br /> Q Complaint <br /> Cther(Please Specify): ❑AccoUNTING <br /> 10 <br /> `BOXED AREA-EHD USE ONLY`"' <br /> • E< -r1'1 oa� +. ^+l'�V G'�4 <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: EHD 48-06 <br /> 1868 E. Hazelton Avenue j Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd com <br />