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1 13'3 01/20/2015 11:03 OAX) P.0011001 <br /> 1 1 <br /> IEl <br /> 1 11DATERECE �i� EHO LOG NUMBER <br /> o❑ SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL. HEALTH DEPARTMENT <br /> cy0 'Cr 1868 East Hazelton Avenue, Stockton, CA 95205-6232 1 <br /> p� '��,`,t���one: (209)468-3420 Fax: (209)464-6138 Web:www.sjgov.org/ehd <br /> @.60-"0,i✓" D <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Rebecca Natal BUSINESS/AGENCY: Advanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP: Stockton/CA/95215 <br /> PHONE (1): 209-467-1006 PHONE(2):209-623-7200 FACSIMILE: 209-467-1118 <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Ploaso allow 10 business days from date of application submittal-•Teneedvo only-must bo confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$125 FEE( C CK LY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 1/20/2015 <br /> Electronic Information: ❑ Llst❑Map—Deacrlptlon: <br /> FILE ADDRESS EHD USE ONLY <br /> Street It Street Name City Unit 1 <br /> 1• 3808 West Lane Stockton <br /> 2. 4040 West Lane Stockton • Unite <br /> 3• 1146 Enterprise Street Stockton ))- / <br /> 4. -.�"1 ]Unit <br /> 5. <br /> S. /Z-�(' l ©Unit 4 <br /> 7. <br /> El Unit 5 <br /> 9. <br /> 10. nit 6 <br /> Specific Date Range of Information Raquostod: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> x❑UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ©HOUSING ABATEMENT SOLID WASTE FACILRYWEHICLE <br /> O OTHERCLEANUP SITE(NON-LOP) ❑FOOD FACILITY X❑WASTE TIRE <br /> x❑UNDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL 0 DAIRY <br /> 0 HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑x TIERED PERMITTED FACILITY ❑MOTEVHOTEL ❑PUMPERTRUCK(YARDICHUCCALT01LEr5 <br /> ❑TATTOOIBODY PIERCING ❑POOUSPAX[]LAND USEAPPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY Il COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:0013M(EXCLUDING HOLIDAYS) <br /> 1. List un 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. Fax to(2091464-0138 or mail to the address indicated above. 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 procassad 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 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 some condition 29 released will be reorganized by EHD staff at the expense of the applicant <br /> Future file reviews by the game applicant may requlra a$125 deposit prior to review. <br /> EHD Lt9E ONLY <br /> EMD 49-06 <br /> Received Time Jan. 20. 2015 10:54AM No. 7929 <br />