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L)r�. c'r. L V V urivi navancea tieotnvlronmentaI No. 6 18 3 P. 1 <br />� DATE RECEIVED E LOG NUMBER <br />SAN JOAQUIN COUNTY <br />Ro'� (�I�v ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main St. Stockton, CA 85202-3029 1 IF <br />021 3 %,r <br />4'#'a <br />ULU w 4 2009 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehid <br />LLftVV 1lt0NMir.N4 "tTI^ <br />ITI PUBLIC RECORDS RELEASE APPLICATION <br />PERWL <br />ly Colavita BUSINESS/AGENCY: Advancad GeoEnvironmental, Inc. <br />ADDRESS: 837 Shaw Road CITY/STATE/ZIP: Stockton <br />PHONE (1): 2o9-467-1oo6 PHONE (2): 209-483-3401 FACSIMILE: 209467-1118 <br />TENTATIVE* APPOINTMENT DATE: ASAV Time: <br />(Please allow 10 business days from date of application submittal - "Tanudve only - mubt be confirmed) <br />❑ CHECK BOX TO EXPEDITE REQUEST - $1 5 F E (C H CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT DATE 12/29/09 <br />Electronic Information: ❑ List ❑ Map — <br />riu»C P1vUrccaa EHD USE ONLY <br />Street 0 Street Name City <br />_� Unit 1 <br />1• 2575 Country Club Boulevard Stockton U� r 06-15 ( k1A 2.3 Unit 2 <br />6. <br />7 �04 <br />8. <br />Unit 3 <br />1a. - <br />nit H <br />Specific Date Range of Information Requested: From to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />NDEROROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT S.O�LID WASTE FACILITYNEHICLE <br />OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY [Q rrASTE TIRE <br />UNDERGROUND TANK (MONITORIWIREMOvAL) ❑ D00 KENNEL ❑ DAIRY <br />HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ WA5TEWATER TREATMENT PLANT <br />❑ TIERED PERMITTED FACILITY ❑ MOTELIHOtEL ❑ PUMPER TRUCKIYARDICHEMICAL TOILETS <br />❑ TATTOOISODY PIERCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br />MEDICAL WASTE FACILITY ❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILA13LL FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:00PM (EXCLUDING HOLIDAYS) <br />1. List uA to ten addresses in the space above. Select the type(s) of files from the list above 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-foradditional assistance with file addresses, 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 flies 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 />3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may be <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 $115 deposit prior to review. <br />5. If you need further assistance, please contact Diane Martinez, at (209) 468-3426. <br />END U E ONLY <br />Ia- r P►�a �1( U 410— <br />EHD 48.08 <br />8!27!09 <br />