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■i UI1U'trcu10 14.43 (FAX) P.0011001 <br /> ■ <br /> ■ ■ <br /> ■ <br /> ■ DATE RECEIVED EHD LOG NUMBER <br /> %mSAN JOAQUIN COUNTY <br /> • ECE6VP ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205.6232 <br /> JAN a 4 2016Telaphone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> ENVIR()NMFNTet ucAr;W PUBLIC RECORDS RELEASE APPLICATION <br /> PERMITISER)&.4r ee ikian <br /> APPLICANT: N BUSINESS/AGENCY!kdvanrad GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITYISTATE/ZiPStockton,CA 95215 <br /> PHONE (1): 2D9367-1006 PHONE(2): 209383-3401 FAX OR E-MAIL:209367-1118 <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 /> ❑ CHECK BOX TO EXPEDITE REQUE - 13 ECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 1/04/2016 <br /> Electronic Information: E] List❑ Map—Descriptlon: <br /> FILE ADDRESS <br /> EHD USE ONLY <br /> Street S street Name city <br /> 1' t.cnh Mar Suet tdanteca <br /> 2. ❑Unit t <br /> 3. <br /> ❑ <br /> Unit 2 <br /> 4. ❑Unit 2H <br /> $ []4jnIt3 v <br /> s. <br /> ❑Unit 3HM <br /> 7 EI,Umt 4 <br /> 6 <br /> �• Q%ITE MITIGATION <br /> 9. <br /> 10. ❑ Unita <br /> Specific Date Range of informatlon Requested: From to <br /> crcrrnvnIAuvTAt.HEALTH DEPARTiri'cNT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MOTELIHOTEL ❑SOUD WASTE FACILITYNEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑FOOD FACILITY <br /> ®UNDERGROUND TANK(MONITORINGIREWVAL) ❑WASTE TIRE ❑DAIRY,POOLISPA <br /> ❑ABOVEGROUND TANK ❑CHICKEN RANCIV DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> ❑HAZARDOUS WASTE ❑MEDICAL WASTE FACILITY ❑PUMPERTRUCWYARDICHEWCALTOILETS <br /> ❑HAZARDOUS MATERIALS ❑TATTOO113ODY PIERCING ❑LAND USE APPLICATION SITES <br /> ❑TIERED PERMITTED FACILITY ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW. MDNDAY-FRIDAYS:DOAtZ-5:OOPM(EXCLUDINGHOLIDAYS) <br /> 1. List ug to tan addresses In the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). AL least one file type MUST be selected. Fax to(209)464-0138 or mall to the addreaa Indicated above Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For esslstance In identifying the nature and content of EHD records,please contact EHD at the number noted above. <br /> 3. The EHD will notify the applicant If any EHD Flies exist An appointment for raview will be confirmed approximately ten(10) <br /> days after recelpt 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 ae released will be reorganized by EHD staff at the expense of the applicant <br /> Future file reviews by the same applicant may require a 8130 deposit prior to review. <br /> AOL "*BOXED AREA-EHD USE ONLY" <br /> ❑ Records provided by Staff-PPR Complete. staff Name: <br /> Received Time Jan, 4, -2016 2 : 36PM No. 0270 <br />