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:Adv nvir To. Fax: (209)464-0138 Page 1 of 1 02/132017 9:50 AM <br /> DAT R 11.•.� " SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> FEb 13 2017 ENVIRONMENTAL HEALTH DEPARTMENT /Q) A <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 V MJ L <br /> &gVi(t(lNA.ENTALMAjL�lephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd 5V O <br /> PEfW,ITISFgVtOES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Jackie Hyman BUSINESS/AGENCY:Advanced Geo Environmental, Inc. <br /> ADDRESS: 3335 E. Miraloma Ave. #142 CITY/STATE2IP: Anaheim CA 92806 <br /> PHONE(1): 500-511-9300 PHONE(2): FAX OR E-MAIL: _jhyman advq o nv com <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 ,, I ..T_$139 FEE(CASH OR CHECK ONLY)- REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 13 FebruarV 2017 <br /> 1. List upto ten addresses in the space below. Select the type(s)of files from the list below by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mall to the address 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 assistance 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 files exist. An appointment for review will be confirmed approximately ten (10) <br /> days after receipt 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 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 $139 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM•5:00PM (EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List ❑ Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES EHD USE ONLY <br /> ®UNDERGROUND TANK(UST) Street# Street Name City <br /> CLEANUP.SNE(LOP) �CONSUMER <br /> OTHER CLEANUP S"(NON-LOP) 1 1113 East Roosevelt Street Stockton k ft� `22 <br /> ®HAZARDOUS WASTE <br /> A��r'/� U D.RY <br /> ®TIERED PERMDTTED FACILRY p `�L/ `h./ <br /> ®ABOVEGROUND TANK 1119 East Roosevelt Street Stockton <br /> ®UST (MONITORING/REMOVAL) <br /> e ,�E O PWS <br /> HAZARDOUS MATERIALS 3 1040 North Union Street Stockton IV <br /> ®SPILURELEASE RESPONSE <br /> ❑SOLID WASTE FACILMY/VEHICLE 4 WATER RVALRY <br /> ❑FOOD FACILITY <br /> ❑POOL/SPA <br /> ❑DAIRY 6 I/\yv� ENE MmDATON <br /> ®LAND USE APPLICATION SITES <br /> ❑SEPTIC PUMPER TRUCK/ HOUSING <br /> 6 <br /> YARD/CHEMICAL TOILETS <br /> ❑WASTEWATER TREATMENT PLANT <br /> ❑HCUSINGABATTMENT T CUPA <br /> �MOTELMOTEL <br /> C NICXEN RANCH/DOG KENNEL CUPA-UST <br /> ❑MEDICAL WASTE FACILIW e <br /> ❑TATTDO/BODY PIERCING <br /> ❑W ASIS TIRE SOLID WASTE <br /> ❑COMPLAINT e <br /> OT1ER(P LEASE SPECIFY): <br /> 10 ALEEVNTXG <br /> -BOXED AREA-EHD USE ONLY— —J <br /> ❑ Records provided by Staff-PPR Complete, Staff Na.: <br /> Received Time—Feb, 13. -2017— 9:46AM—No. 0830 <br />