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03116/201111 08:39 Advanced Gitnviromental Inc. 209 4671118 P.0011001 <br /> HAM NAV NOWAN3 SAN JOAQUIN COUNTY EHO LOG NUMEER <br /> ENVIRONMENTAL HEALTH DEPARTMENT 6\05 <br /> 5 <br /> 11H 9 T �Vl'`i 600 East Main St. Stockton, CA 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.Sjgov.org/ehd <br /> 3- A130 PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:_ Ally C alavita BUSINESS/AGENCY'-Advanced C:anFnyironmPnf^I <br /> ADDRESS: __837 Shaw Road CITYISTATEOP: StOCkton/CA/95215 <br /> PHONE(1): 209-467-1006 PHONE (2):209-483-3401 FACSIMILE: 209-467-1118 <br /> TENTATIVE*APPOINTMENT DATE: s Time: <br /> (Please allow 10 business days from data of application submittal•7antal/ve only•must be connrmed) <br /> C] CHECK BOX TO EXPEDITE REOUgST-$11F� EE j£A$H OR CHECK ONLY)-REQUEST PROCESSED 1113 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT_ (/J�/l.3yC7J c(/f/p�i-� DATE /(,4(j <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> r�Street rp Street Name City Unit <br /> nit 2- <br /> 3. <br /> ti Unit 9 <br /> ' nR 4 <br /> 8. <br /> 9. El Unit$ <br /> 10. <br /> nl!8 <br /> SPiclfic Data Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SHE(LOP) ❑HOUSING ABATEMENT <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ®SOCIO WASTE FACILNYNEHICLE <br /> ®UNDERGROUND TANK(MONITOR(NOIREMOVAL) ❑DOG KENNEL ®WASTE TIRE <br /> ®HAZARDOUS WASTE GENERATOR DAIRY <br /> ❑CHICKEN RANCH ®WASTEWATER TREATMENT PLANT <br /> ®TIERED PERMITTED FACILITY []MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICALTOILETS <br /> ❑TATTOO/BODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ® MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARL AVAILA13LE FOR REVIEW: MONDAY-FRIDAY 8:00 AM.15:00PM(EXCLUDING HOLIDAYS) <br /> 1, i lel unto tan addresses In the space above. Select the types)of fllea from the list above by checking the appropriate <br /> box(ae). At Ieaat ono Nle type MUST be selected. Fax to(2081484.0138 or mall to the addreaa indicated ahova Address <br /> ranges will not be accepted•for additional assistance with file addresses,contact the EHD. Applications received after <br /> 8:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant If any EHD Oleo exist. An appointment for review will be confirmed Rpproxlmately ten(10) <br /> days after receipt of application. The Oleo will behold for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that to actively being worked on by EHD staff may not be Immediately available for review. A now application may be <br /> submitted when the Nle 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$116 deposit prior to review. <br /> 6. If you need further assistance,please contact Diane Martinez,at(209)498.3426. <br /> eaDuae NAY <br /> NHD as.oe <br /> annoa <br />