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0812312010 15:51 Advanced GeoEnviromental Inc. ­0209 4671118 P.0011041 <br /> Lt::.. SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENNIR(*MENTAL HEALTH DEPARTMENT <br /> int.! 2 3 '010 - <br /> 600 East Main Street, Stockton, CA 95202-270$ oow* Toq <br /> FNV Ruf'Elfl'itili k f i:El phonc,(209)468-3420 Fax: (209}464-0138 Web:�uww.sjgay.org d <br /> PER N111T/SE1R"U1'8F§ <br /> PUBLIC RECORDS RELEASE APPLICATION _ <br /> APPLICANT:��-.--- j1 Sc AA BusINESSIAGENCY: C£ ( �!0 t!�r Mr,44 <br /> ADDRESS: 5 Aw Ro 0 <br /> PHONE(7): Z- t! — PHONE(2); FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE: Tima: <br /> (Please allow 10 business days from date of application subrnittal-*Tentative only-must be confirmed) <br /> 0 CHECK BOX'TO EXPEDITE REQUEST-08.o0 rCE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 E3USINESS DAYS <br /> SIGNATURE OF APPLICANT tyy���, ,ta��— DATE g31 Z Cl n <br /> Electronic Information: 0 List Q Map description: <br /> FILE ADDRESS".`_ EHD USE ONLY <br /> Street# street Name city Q Unit 1 <br /> woo <F 'r.- -��GrMnnfi ��. SSG <br /> 2, I © Unit 2 <br /> 3. <br /> 4, <br /> ! ' <br /> nit 4 <br /> 6. <br /> 7. <br /> © Unit 5 <br /> 8. <br /> 9. <br /> ❑ Unit ti <br /> 'k 4. <br /> Specific Date Range of Information Requested.From 9 9 7 to 1199 <br /> 44. <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> Fl UN{JERGROUND TANK(UST)CLEANUP SITE(LOA) M HOUSING ABATEMENT 0 SOLID WASTE FACILITYNEHICLE <br /> 10 OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY C1 WASTE TIRE <br /> 0 UNDERGROUND TANK(MONITORINOIREMOVAL) Q Doo KaNNeL 0 DAIRY <br /> 0 HtzARDOUs WASTE GENuRATOR CI CHiamisl RANG" 0 WASTEWATER TREATMENT PLANT <br /> 0 TIERED PERNIRTED FACILITY 0 MOTELIHOTEt- 0 PUMPER TRUCKIYARDIG}{EmTOILETS <br /> 0 TATTOoIUODYPIERCING ❑POWSPA t7 LAND UBE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY CI OTHER(PLEASE SPECIPY) <br /> WF,LL ANV:SEPTIC PERMIT RECORDS ARE AVWI AgLe FOR REVIEW - MONDAY FRIDAY$:00 AM-5:00PM - EXCLUDING HOLIDAYS. <br /> 1. Llst up to ten addresses In the space ab6m;Solect the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be sleeted. Fax to(209)464-0136 or mail to the address indicated above,. Address <br /> ranges will not be accepted—for addltional 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 appolntmer,t for review will be Confirmed approximately ten(10) <br /> days after receipt of applleaHon. The files will be held for a maximum of five businass days for review. Appointments <br /> should bs 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 avallable. <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 fila reviews by the Sartre applicant may require a$98.00 deposit,prior to review, <br /> EHD USE ONLY <br /> If you should need further assistance please contact btane Martinez (D (209)468-3425 directly. Thank You*** <br /> EHoa -06 a/1412 <br /> I , <br />