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RECEIVED <br /> SAN J DAQ U I N MAR 2 3 2013 Environmental Health Department <br /> ----COUNTY--- PUBLIC RECORDS RELEASE APPLICATION <br /> -T ENVIRONMENTry <br /> PERMIT/SE aLwgBYEMAIL / <br /> EHD LOG NUMBER: <br /> 74 <br /> APPLICANT: Rebecca Natal BUSINESS/AGENCY:Advanced GeoEnvironmental,Inc. <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP:Stockton,California 95215 <br /> PHONE (1): 209-467-1006 PHONE(2):209-623-7200 FAX OR E-MAIL: rnatal@advgeoenv.com <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrangi n ppoin �rriidat a time to review the requested records. <br /> SIGNATURE OF APPLICANT DATE 3/23/2018 <br /> 1. List up to ten addresses in the space below. Address ran es W L NOT be accepted. Select the type(s)of files from the <br /> list below by checking the appropriate box(es). At least one fild type MUST be selected. Fax to(209)464-0138,mail to the <br /> address indicated below, or email to info(o�sicehd.com. Applications received after 3:00 pm will be processed the next <br /> business day. <br /> 2. For assistance in identifying the nature and content of EHD records, please contact EHD u ern to below. <br /> 3. The EHD will notify the applicant if any EHD files exist. An appointment for review will bei ap I n (10) <br /> days after receipt of application. The files will be held for a maximum of five business da f r viv. meis <br /> should be scheduled accordingly. <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$152 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List ❑ Map -Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT ( P y g accepted) EHD �E ONLY <br /> FILES (Specific addresses only,address ranges will not be acce ted � �/� <br /> 3 � '` <br /> QX Underground Tank(UST) Street# Street Name City �lJ <br /> Cleanup Site(LOP) F{w ? ❑CONSUMER <br /> Q Other Cleanup Site(Non-LOP) ' 3805 West Lane Stockton IaW v / _ �(/ <br /> W l �j ( t-i/ Ute <br /> Q Hazardous waste NM1, <br /> QX Tiered Permitted Facility 2 1621 N Broadway Ave Stockton f �� r./ 5aa O DnIRv /11 -1 <br /> Q Aboveground Tank 1 /I1�((/�j� <br /> Q UST (Monitoring/Removal) ❑PWS ° <br /> Q Hazardous Materials 3 l <br /> Q Spill/Release Response <br /> Solid Waste Facility/Vehicle 4 WATER QUALITY <br /> Food Facility <br /> Pool/Spa SITE MITIGATION <br /> Dairy 5 <br /> 0 Land Use Application Sites <br /> ❑ <br /> Septic Pumper Truck I 6 HOUSING <br /> Yard/Chemical Toilets <br /> Wastewater Treatment Plant CUPA <br /> Housing Abatement T AST I HM I HW <br /> Motel/Hotel <br /> 7 Chicken Ranch/Dog Kennel CUPA <br /> Medical Waste Facility 8 UST <br /> Tattoo/Body Piercing <br /> SOLID WASTE <br /> ®Waste Tire 9 <br /> 0 Complaint <br /> Other(Please Specify): ❑ACCOUNTING <br /> 10 <br /> ***BOXED AREA-EHD USE ONLY <br /> 3-�- •`1"- Cv-ti:t l t � Cu'-t `trw.z., --,• o PP 2� w,�a�r-,e!���cQei n �.e, wt l`� <br /> ❑ Records provided by Staff-PPR Complete. staff Name: EHD4a-os <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />