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02/1912014 11:19 . P.0011001 <br /> I� <br /> DATE RECEIVED SAN JOAQUIN COUNTY EHO LOG NUMBER <br /> RECEIVE[, ENVIRONMENTAL HEALTH DEPARTMENT <br /> FEB 19 2014 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> ENIARONMENTAL HEALTFI <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Rebecca Natal BUSINESS/AGENCY: Advanced Ge0Envlronmental <br /> ADDRESS: 637 Shaw Road CITYISTATE2IP: Stockton /CA/95215 <br /> PHONE(1): 209-467-1006 PHONE (2): 209-623-7200 FACSIMILE: 209-467-1118 <br /> TENTATIVE`APPOINTMENT DATE: ASAp Time; <br /> (Please allow 10 business days from date of application submittal-•Tontartwa only-must be confirmed) <br /> ❑ CHECK BOX TO E(PEDI U -$126 FEE( R CH K O - -REQUEST PROCESSED IN 3 BUSIN SS DAYS <br /> SIGNATURE OF APPLICANT DATE °I <br /> Electronic Informatlon: ❑ List❑Map—Description: <br /> _ FILE ADDRESS EHD USE ONLY <br /> Stmot4 Street Name city - Unft1 <br /> 1. 56 South Lincoln Street Stockton <br /> 2, 402 West Weber Avenue Stockton .-u K2 <br /> 3. 666 West Weber Avenue Stockton `i <br /> 4• 504 West Weber Street or Ave Stockton El u its 8, Ej 6nh 4 <br /> 7, l <br /> 2h(e;Y <br /> L9. <br /> Unit 5 <br /> , Unit e <br /> Specific Data Pangs of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> x❑UNDERGROUND.TANK(UST)CLEANUP SITE(LOP) ❑HOUSINGABATEMENT D SCUD WASTE FACILIn'NEHICLE <br /> x❑OTHERCLEANUPSITE.(NON-LOP) ❑Fo00FACILITY ❑x WASTETIRE <br /> x❑UNDERGROUND TANK(MONITORNWRBJDVAL) ❑DOG KENNEL ❑x DAIRY <br /> x❑HAZARDOUSWASTE GENERATOR ❑CHCKLM RANCH ❑WASTEWATER TREATMENT PLANT <br /> Z TIERED PERMITTED FACILITY ❑MOTEUHOTEL ❑PIDAPERTRUGWYARDICHENCALTOILETS <br /> ❑TATTOCIBODY PIERCING ❑POOUSPAx❑LAND USE APPLICATION SITES <br /> ❑ MEDICALWASTEFAGLITY ❑COMPLAINTRECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-S:00PM EXCLUDING HOLIDAYS) <br /> 1. List un to ten addresses in the space above. Select the type(e)of files from the list above by checking the appropriate <br /> box(ea). At least one file type MUST be selected. Fax to(209)464-0138 or mall to the address indicated above. Address <br /> ranges will not be accepted•for additional assistance with file addressee,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 flies exist An appointment for review will be confirmed approximately ten(1 D) <br /> days after receipt of application. The flies 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 appllcatIon 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 same applicant may require a$125 deposit prior to review. <br /> END USE ONLY <br /> EMD 49,09 Bl1H1 <br /> Received Time Feb. 19. 2014 11 : 11AM No. 5231 <br />