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F0 08/15/2014 16:50 (FAX) P.001/001 <br /> Ip❑❑ <br /> I ❑ DATE RECEIVED EHD LOG NUMBER <br /> SAN .10AQUIN COUNTY <br /> . -� f-:� �► ENVIRONMENTAL HEALTH DEPARTMENT (� G <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> AUG .L 5 2014 Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPi...ICATION <br /> APPLICANT: Rebecca Natal BUSINESS/AGENCY; Advanced GeoEnvironmental <br /> • J <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP; Stockton /CA 195215 <br /> PHONE(1): 209-467-1006 PHONE(2):209-623-7200 FACSIMILE: 209-467-1110 <br /> TENTATIVE'APPOINTMENT DATE: ASAP Time: <br /> (Pleaso allow 10 business days from date of appllcatlon submittal-"Tantativo on y-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑List❑Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# ? ;S(roat Name City Unh 1 <br /> 1- 8010 = '-11 Street t`` ; 3`i`C, `0ye'Trac f <br /> 2. 8111 11th Street i `' 'zit Ek,='`Trac <br /> RUnk 2 <br /> 3 8181 11th Street I`t�1� z` �� 23 (' Trac <br /> a• 1000 11 th Street 7 u 1'.,771�Lf Tracy IDUnit 3 <br /> !3. <br /> 6. /lam u Ito <br /> 7. <br /> 8. Unit 6 <br /> 8. <br /> 10. .o 6nit 6 <br /> Specific Date Range of information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT F=ILES <br /> x❑UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT Q SOLID WASTE FAGILITYNEHICLE <br /> x❑OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑Q WASTE TIRE <br /> D UNDERGROUND TANK(MONITORiNG1REMOVAL) ❑,D:OG KENNEL- Q DAIRY <br /> Q HAZARDOUS WASTE GENERATOR ❑CKCKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> Q TIERED PERMITTED FACILITY ❑MOTEUHOTEL ❑PUMPERTRUCK/YARDICHEMICALTOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOUSPA Q LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑X COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-S:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresegm 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. Fax to(209)464-0138 or mall to the address indicated above. Address <br /> ranges will not be accepted-for additional asslstance with file addresses,contact the EHD. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. 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. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be Immediately available for review. A new application may be <br /> 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 of the applicant. <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. <br /> EHD USF.ONI.V <br /> EHD 48.00 611111 <br /> Received Time Aub, 15. 20141, 4:39PM No. 6845 <br />