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03/17/2005 14:11 2094671.11 <br /> !i <br /> 1 I END LOG NUMDER <br /> mn <br /> , f..✓ Srr Jo�,Q Com x <br /> ,NMONWNTALIRALTHMPARTMENT q6 <br /> 304 E Weber Ave 3 -Floor Stockton.CA 95205 <br /> to" 1 7 70 �09)468-3420 Fax: (2.09)464408 Web:www.ca.Sa11joaquin.ca.us/ehd <br /> NViRONRFchT HEALTH PUBLIC RECORDS RELEASE APPLICAMON <br /> !; Advanced GeoEnviranmental,Ina <br /> BUSINESWAGENCY:. _-.. . <br /> APPLICANT: <br /> ApvRE33:, 837 Shaw Road,Stockton,CA 85215 ,k <br /> P " " 945 <br /> 207-1 1 18 <br /> 2()9 67 FACSIMILE:„ <br /> PHONE,:— <br /> TENTATIVE"AjPOINrMENT DATE: <br /> (Please allow 10 busloos8 days from data of application submt�l) <br /> CHECK BOX TO F-XPE131TE REQU 93.00 FEE-REQUEST PFPCESSED IN 3 BUSINESS DAYS <br /> DATE <br /> SIGNATURE OF APPLICANT <br /> Department use Only <br /> UNIT <br /> FILE ADDRESS <br /> CX ❑ Unit 1 <br /> 1. sheee � e`.-Lo <br /> z. Unit 2 a, <br /> 3 3\ <br /> n. sceet �i Gnit 3 <br /> e. saeai <br /> a . <br /> 7. Street <br /> e. U <br /> n it 5 - <br /> a. sues . <br /> I . <br /> 16. StrBe1 <br /> ENVIRONMt^NTAL HEALTH DEPARTMENT FILES <br /> UNDERGI�OUNd TANK(UST)CLEANUP S1TE{LOP): ❑ HOUSING ABATEMENT E3 SOLID WASTE VACILITY <br /> )C OTHER CLEANUP 817E(NON-LOP) r b 'FOOD FACILITY p SOLID WASTE VEHICLE <br /> VIL UNDERGROUND TANK(MONITORINGIREMOVAL) .! CI :DOGKENNEL C❑I DAIRY <br /> �; ❑°-CHICKEN RANCH PKG TREATMENT PLANT <br /> HAZARDOUS WASTE GENERATOR 1 ❑p;MOTEIJHOT�CL 13 PUMPER TRUCK►YARDICHEM TOILETS <br /> TIERED PERM rrTED FACpsTY C] LAND USE APPLICAM74 SITES <br /> M TATTO018ODY PIERMI IQ Ca 'POOLISPA <br /> 0 MEDICAL,WASTE FACILITY C3:,OTHER{PLEASE SPECI <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to 1208 464.0138 ar mail to the <br /> address Indicated v ; <br /> 2. : EHD Will notify the applicant if any EHD les exist, An appointment for review will be confirmed <br /> approximately five business days but in later than ten(10)days after receipt of application. The files <br /> will be held for a maximum of f1V 'busln ss days for review. Appointments should be scheduled <br /> accordingly. T. A <br /> 3. A file that is actively being worked on b EHD staff may not be Immediately available for review. Anew <br /> application may be submitted when the le Is available. <br /> 4. Any file not returned In the same conditi D OS released will be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by t e same applicant may require a$93.00 deposit prior to review. <br /> S.. <br /> *TENTATIVE appointment dates must:be Confirmed with EHD staff. <br /> 6. Applications received after 3:01�pm will a processed the next business day. <br /> TI <br /> Ap'pik {UlE�kT DAT <br /> OWl .. . <br /> ++ .1 <br /> 00.6 NN <br /> •,tN!`TfA <br /> :YES::„.;• <br /> ATE <br /> :N <br /> -FiEYI[ 13: - - - - <br /> Etmaanz.aoc <br /> 4 'I i, <br /> d <br />