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QCEIVE® <br /> SAN JOA <br /> JUN 2 2018 PUBLIC <br /> Health Department <br /> —COUNTY— PUBLIC RECORDS RELEASE APPLICATION <br /> • uiness aror,s tNVIRONMENTAL (0V9571 <br /> PERMITISERV! I BY EMAIL `/ <br /> EHD LOG NUMBER: <br /> APPLICANT: Rebecca Natal BUSINESSIAGENCY:Advanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP:Stockton,California.95215 <br /> PHONE(1): 209-467-1006 PHONE (2):20-623-7200 FAX OR E-MAIL: Rnatal@advgeoenv.com <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 -'_G,'9 DATE 612/2016 <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)464-0138,mail to the <br /> address indicated below,or email to infoCa)sicehd.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. U/2.d <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-5:00PM(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 p ) EHD USE ONLY <br /> FILES (Specific addresses only,address ran es will not be acce ted <br /> ❑X Underground Tank(UST) Street# Street Name city <br /> Cleanup Site(LOP) 7 1931 E Oak St Stockton ❑ConsumI <br /> • Q Other Cleanup Site(Non-LOP) <br /> Q Hazardous Waste t{Nn NM/IAyI ❑DAIRY <br /> IJ Tiered Permitted Facility 2 1722 E Flora St Stockton <br /> Q Aboveground Tank <br /> IX1 UST (Monitoring I Removal) � PWS <br /> Q Hazardous Materials a 1903 E Fremont St Stockton <br /> Q Spill I Release Response /nJ tl <br /> LLQ i'1 I ATE m <br /> 71 Solid Waste Facility/Vehicle 4 1960 E Fremont St Stockton I (4) <br /> E] FoodFacility ` —T" <br /> ❑Pool I Spa i-tf�rTryt ITE arrIGATIO. <br /> Dairy _/ 5 1908 E Fremont St Stockton <br /> Q Land Use Application Site"Y' <br /> VVV �" V„41tG3 ❑Houswo <br /> ❑Septic Pumper Truck/ a 2001 E Fremont St Stockton <br /> Yard/Chemical Toilets <br /> Q Wastewater Treatment Plant FtrM,n\HW�y6 UPA <br /> Housing Abatement 7 2010 E Fremont St Stockton f `t AST]HM IHW <br /> Motel/Hotel Chicken Ranch/Dog Kennel �kha 2040 E Fremont St Stockton 1 OUPA <br /> UST <br /> El Medical Waste Facility `t <br /> Tattoo/Body Piercing p SOLID WASTE <br /> Waste Tire a <br /> Q Complaint <br /> ❑Other(Please Specify): - ❑Aocouxnuc <br /> to <br /> "**BOXED AREA-EHD USE ONLY... <br /> ❑ Records provided by Staff-PPR Complete. staff Name: EHD 49-o6 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />