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An V It 141 LV 14 VJ.VI P.0011001 <br /> ■ <br /> ■ <br /> ■■■ QATIRE <br /> sD � EHD LOG NUMBER <br /> ■ ti P-� u, ��1 SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> JAN 1.4 2014 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov,org/ehd <br /> E!`VIRONi,6EIjAL HEAL-1H r <br /> pERf+fIi�SE l-tl,/t�;l�� 11� <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Rebecca Natal BUSINESS/AGENcY: Advanced GeoEnylronmental <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP: Stockton /CA /95215 <br /> PHONE (1); 209-467-1006 PHONE(2); 208-623-7200 FACSIMILE: 209-467-1118 <br /> TENTATIVE*APPOINTMENT DATE: ASAP Time: <br /> (Please allow 10 business days from date of application submittal-'Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REgUEST-$125 FEE111 GR CF ONLY}-REG UEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLfCANT /P , DATE 111y LA <br /> Electronic Information: ❑ List❑ Map- Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Namecity % Unit 1 <br /> 1. 2431 Mariposa Road Stockton 11,T Vd( f <br /> 2• 2467 Mariposa Road Stockton 44 ,'Unit 2 it <br /> 3• 2501 S. Route 99 W. Frontage Rd; StocktonO' <br /> 4• 2459 Mariposa Road Stockton ] Unit3 f/ <br /> 5• 2373 Mariposa Road ✓ Stockton /ter v'' / -� <br /> g 2701 South Highway � <br /> 99 Stockton � �� 0 Unit4 <br /> 7 2327 Mariposa Road ✓ / Stockton �� ' <br /> B 2447 mariposa Road — Stockton 'aF �nl 5 <br /> 9. <br /> '0 Unit 8 <br /> Speclflc Date Range of Information Requested: From all to ` <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ❑x UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITYNEHICLE AtO �ut,, L=-'L--, <br /> x❑OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑x WASTE TIRE <br /> ❑x UNDERGROUND TANK(MONITORING/REMOVAL) ❑DOG KENNEL Rx DAIRY �— <br /> ❑x HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> TIERED PEM=D FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCK/YARD/CHEMICALTOILETS <br /> ❑TATTOO/BODY PIERCING ❑POOUSPA Q LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY Q COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REmEw: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addressee In the space above. Select the type(6)of files from the list above by checking the appropriate <br /> box(es). At least one flie type MUST be selected. Fax to(209)484-0138 or mall to the add s Indicated above Address <br /> ranges will not be accepted-for additional assistance with file addreases,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 flles exist. An appointment for review will be confirmed approximately ten(10) <br /> days after recefpt of application. The fifes will be held for a maximum of five busfness 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 Immedlately evallable for review. A new application may ba <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 /> FHO USE ONLY <br /> EHD 4A-0A ' <br /> 611111 <br /> ,eived Time Jan. 14. 2014 9: 01AM No. 4997 <br />