Laserfiche WebLink
I 12/21/2012 16:12 Advanced GeoEnviromental Inc. ffAX)209 4671118 P.0011001 <br /> ATE RECEIVED SAN .IOAQUIN COUNTY END LOG NUMBER <br /> 9Q�� <br /> I ���� ` <br /> 1 4i ENVIRONMENTAL HEALTH DEPARTMENT <br /> DEL 21 201 1868 East Hazelton Avenue, Stockton, CA 95205-8232 /)/ <br /> elephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd / <br /> ENVIRONMENTAL HEALTH <br /> 7S <br /> PERMIT9ERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Ally Colavita BUSINESS/AGENCY: Advanced GeOEnvironmental <br /> ADDRESS: 837 Shaw Road CITY/STATErLIP: Stockton / CA / 95215 <br /> PHONE(1): 209-467-1006 PHONE (2): 209-483-3401 FACSIMILE: 209-467-1118 <br /> TENTATIVE`APPOINTMENT DATE: ASAP Time: <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQU T-$1'17"'777 <br /> 5 FE CAS R HECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 12-LZt /r 2 <br /> Electronic Information: ❑ List❑ Map— Description: <br /> FILE ADDRESS EHD USE ONLY <br /> street a Street Name City Unit 1 <br /> 1. 18754 East State Route 26 Linden <br /> 2• Un1t 2 <br /> 3. <br /> 4. ZUnik <br /> 6• Unit 4 <br /> T. <br /> 8• El Unit 6 <br /> B. <br /> 10. nit e <br /> Specific Data Range of Information Requested: From all to <br /> OF <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> Ej UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSINO ABATEMENT E]SOLID WASTE FACIUTYNEHICLE <br /> X❑OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY Q WASTE TIRE <br /> (LI UNDEROROUND TANK(MONn FdN0IREMOvAL) ❑OOG KENNEL Q DAIRY <br /> Q HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> I]TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICALTOILETS <br /> ❑ <br /> TATTOO/BODY PIERCING ❑POOLISPA ❑x LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY Q COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 Am-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addressee In the apace above. Select the type(e) 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 Indlcg!pAALqve. Address <br /> ranges will not be accepted -for additional assistance 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 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 he 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 some applicant may require a$125 deposit prior to review. <br /> E11D USE ONLY <br /> r........ aHHi <br /> Received Time Dec. 21. 2012 4: 09PM No. 1952 <br />