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Ism 1011312014 17:01 (FAX) P.0011001 <br /> IDr�-jj <br /> EHD LOG NUMBER <br /> INSP ME D SAN .JOAQUIN COUNTY <br /> R- VIRONMENTAL HEALTH DEPARTMENT <br /> EN <br /> OCT 13,2014 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.orq/e d 7/57 <br /> ENVIRONMENTAL HEAL N, <br /> PERMITISERVICE a PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:—Reber—ca Natal BUSINESS/AGENCY: Advanced GeoEnvironmental <br /> ADDRESS:, '-837 Shaw Road CITY/STATE/ZIP; Stockton /CA /95215 <br /> PHONE(1): 209-487-1006 PHONE(2): 209-023-7200 FACSIMILE: 209-467-1118 <br /> TENTAT/VE'APPOINTMENT DATE: ASAP Time: <br /> (Please allow 10 business days from aate of applicaon submittal-"rentauve only-must be con <br /> ❑ CHECK BOX TO EXPEDITE RE •$125 FEE( 0 C C Y)-REQUEST PROCESSED IN 3 BUSI SS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic information: ❑ List❑ Map—Descrlpti n: <br /> FILE ADDRESS EHD USE ONLY <br /> Street 0 Shoot Name city LnIt1 <br /> 1• 740 North Cluff Ave Lodi <br /> 2. 802 North Cluff Ave Lodi / unit2 <br /> R/ 3- 1333 •Ea Turner Rd Lodi 2� <br /> 4. q q' qqlq, q �jOLqqq3nit 3 <br /> a. i -7 y D <br /> 6. 1 <br /> Unft4 <br /> 7. <br /> g, Unit 6 <br /> 10. DC7 i Unit 6 <br /> Specific Date Range of Information Requested: From all to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> x❑UNDERGROUND TANK(UST)CLEANUPSTTE(LOP) ❑HOUSINGA13ATEMENT ❑x SOLID WASTEFACILIiYNEHiCLE <br /> X OTHER CLEANUP SiTE(NON-LOP) ❑FOOD FACILITY Q WASTETIRE <br /> X1 UNDERGROUND TANK(MONiTORINGIREMOVAL) ❑DOG KENNEL DAIRY <br /> 0 HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> FAI TIERED PERMITTED FACILITY ❑MOTEUHOTEL ❑PUMPER TRUCKIYARDICHEMICALTOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOLISPA [fl LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY 0 COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:0OPM(EXCLUDING HOLIDAYS) <br /> 1. List un 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 leant one file type MUST be selected. Fax to(208)464-0138 or mall to the address indicated above. Address <br /> ranges will not be accepted-for additional 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 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 /> 3. A file that is actively being worked on by EHO 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$125 deposit prior to review: <br /> EHD U$E ONLY <br /> END 48-09 x1111 <br /> Received Time Oct. 13, 2014 4:45PM No- 7321 <br />