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INN 04/2512014 17:41 AX) �s P.0011001 <br /> DATE RIC ; ,;' W6 LOG N1IMDEFt... <br /> will E� SAN JOAQUiN COUNTY I I <br /> (ENVIRONMENTAL HEALTH DEPARTMENT <br /> { <br /> APR 2S 2014 1868 East Hazelton Avenue, Stockton, CA 95205-6232vA <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> ENVIRONMENTAL HEALIN . <br /> PERMIMSERMCES PUBLIC RECORDS RELEASE APPLICA'T'ION <br /> APPLICANT: Rebecca Natal BUSINESS/AGENCY: Advanced Ge oEnviron mental <br /> ADDRESS: 837 Shaw Road CITY/STATE/ZIP: Stockton/CA 195215 <br /> PHONE:(1): 209-467-1006 PHONE(2): 209-623-7200 FACSIMILE: 209-467-1118 <br /> TENTATIVE`APPOINTMENT DATE: ASAP Time: <br /> (Please allow 1 D business days from date of application submittal-"Tentative only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQ -$125 FEE( CK O VEST PROCESSED IN 3 BUSINESS QA S <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑List❑ Map—Descriptio : <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City p Unit 1 <br /> 1. 300 West Pine Street Lodi +J°b Cr'-1>P <br /> 2. 12 Church Street Lodi NCI �,,� Unite <br /> 230 Elm Street Lodi < <br /> G4 124 Elm Street Lodi T+w LST ° !VfffUnit 3 <br /> s. 107 School Street Lodi us— ,uaco�P <br /> 8• + Unit4 <br /> 7. <br /> tI. J 0 Unit 6 <br /> 9. <br /> 10. p°iunit s <br /> Specific Date Range of Information Requested: From All to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> OUNDERGROUND TANK(UST)CLEANUPSITE(LOP) ❑HOUSING ARATMOT E]SOLID WASTE FACILTTYNEHICLE <br /> Q OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY 0 WASTE TIRE <br /> UNDERGROUND TANK(MDNiTORiNGiREMOVAL) ❑DOG KENNEL 0 DAIRY n _ <br /> x0 HAZARDOUS WASTE GENERATOR ❑C[OCKEN RANCH C]WASTEWATERTREATMENT PLANT <br /> TIERED PERMITTED FACILITY MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEWCAL TOILETS <br /> ❑TATTOOi13ODY PIERCING ❑POOL/SPA LAND USE APPLICATION SiTES <br /> ❑ MEDICAL WASTE FAUUTY Q COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> W ELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY S:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List up to_ten addrsseea In the space above. Select the type(s)of files from the Ilst above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address Indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received afGar <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten(10) <br /> days after recolpt 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 END staff may not be Immediately available for review. A new application may be <br /> submitted when the file Is available. <br /> 4. Any Elle 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$126 deposit prior to review. <br /> ':Z:?'`b- 14 d ICL 0� �S 2�� `JT IrlS}ZiU <br /> 1(� a - OIL- --w- <br /> E ase _. _ Willi <br /> Received Time_'Apr. 25. 2014 5: 30PM No. 5904 <br />