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am c 10126/2015 09:02 (FAX) P.0011001 <br /> m m <br /> mQ <br /> s <br /> m <br /> no: REG&I VED EHD LOG NUMBER <br /> a SAN JOAQUIN COUNTY <br /> OCT Z 8 2015 ENVIRONMENTAL HEALTH DEPARTMENT <br /> • 1668 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ENVIRONMENTALHEAETTT plaphons: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Jennifer Berjlklan BUS INESS/AGENCY?dvanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Road CITYISTATEIZIP: Stockton,CA 95215 <br /> PHONE (1): 2094167-1006 PHONE (2). 209-083-34bl FACSIMILE:209-467-1118 <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 Sax TO EXPEDITE REQUE /CASH OR CHECK ONLY)-REQUEST PROCESSED IN tEHEINESSUAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ Llst Map—Description; <br /> FILE ADDRESS <br /> Street# Street Name City EHD USE ONLY <br /> 1. 825 Navy Drive Stockton <br /> 2. 1137 South Stockton Street Stockton M Unit 1 <br /> 3. 1240 Navy Drive Stockton <br /> ❑ Unit 2 <br /> 4. 1145 West Charter Way Stockton ED Unit 2H <br /> ti <br /> 5- 939 West Charter Way Stockton <br /> • S• /f It3 <br /> 7. [9Unit4 <br /> 8• . ,SIN MITIGATION <br /> 9. <br /> 10. 'Unit 5 <br /> Specific Data Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES i <br /> ^�/UNDERGROUND TANK(UST)CLEANUP SITE(LOP) El MEDICAL WASTE FACILITY Q SOLID WASTE FACILITYN-eHICLE <br /> I.MOTHER CLEANUP SRF(NON.IOP) _n Ho sitis ABATFmLNT WASTE TIRE <br /> ❑'UNDEROROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ©'PROVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> _'HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTEL(HGTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑�06USPA ❑LAND USE APPLICATION Srrrs <br /> ❑TATTOOIaODY PIERCING Q COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM•5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses In the space above. Select the type(s)of files from the IW above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to f209)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 clay, <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 N any EHD files exist. An appointment for review will be confirmed approximately ten(10) <br /> days after recelpt of application. The files will behold 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 EMD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$130 deposit prior to review. "'BOXED ARRA-EHD USE ONLY' <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> eao"At V1116 <br /> Received Time Oci. 28, 2015 8 , 54AM No. 9891 <br />