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to 1211212014 09:10 (FAX) P.0011001 <br /> I111111� DATE RECEIVED EHD LOG NUMBER <br /> SAN JOAQUiN COUNTY <br /> ■ ENVIRONMENTAL HEALTH DEPARTMENT <br /> ' DEC 12 2014 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209) 464-0138 Web: www,sjgov.org/ehd <br /> ENV!90NME-ENTAI_;-.EAL:f <br /> PEFiItJiFTlIr9ViCLS <br /> PUBLIC RECORDS RELEASE APPLICATIM <br /> APPLICANT:Jennifer Ber'ikian BUSINESS/AGENCY:Advanced GeoEnviron mental <br /> ADDRESS: 837 North Shaw Road CITY/STATE/ZIP: Stockton, CA <br /> PHONE (1): (209)467-1006 PHONE (2):(209)483-34'01 FACSIMILE: (209)467-1118 <br /> TENTATIVE"APPOINTMENT DATE: ASAP Time: <br /> (Please allow 10 business daZgJro date of agpllcation submittal.*'Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE JREQ T-$12 (CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINE S DAYS <br /> SIGNATURE OF APPLICA DATE <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name Clty Unit 1 <br /> �. 2881 Navone Road Stockton <br /> 2. 21'unit 2 <br /> 3. <br /> 4, Unit 3 <br /> 5. <br /> g, 1-1 Unit 4 <br /> 7. <br /> $. n 6 <br /> Unit 8 <br /> Specific Date Range of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> X1 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT Q SOLID WASTE FACILITYNEHICLE <br /> x0 OTHER CLEANUP SITE(Now-LOP) ❑FOOD FACILITY ❑x WASTE TIRE <br /> Q UNDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL Q DAIRY <br /> RI HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> Q TIERED PERMITTED FACILITY ❑MOTEt1HOTEL ❑PUMPER TRUCKIYARDICHEMiCAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOLISPA LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY 0 COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE:FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:0OPM EXCLUDING HOLIDAYS <br /> 1. List up to ten jaddresses in the apace 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. Fox to 209 4 ll to the addIreau Indirotad above. Address <br /> ranges will not be accepted-for additional aeslstance with file addresses, contact the EHD. Applications received after <br /> 3:00 pm will be processed the next buslness day. <br /> 2. The EHD will notify the applicant if any EHD flies exist An appointment for review 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 /> 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 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 requlra a$125 deposit prior to review. <br /> NO USE ONLY <br /> Received Time_Dec, 12• _2014_ 8:49ANLNo, 7704 011,11 <br /> EHD 48.09 <br />