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DATE . . _ AN„TO 1.11 11 ,w , v. v7u� EHI' - [ NUMBER <br /> SAN J AQUIN COUNTY <br /> REC <br /> (r EN'VIONMENTAL HEALTH DEPARTMh,,aL�U 1 D 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sj ov <br /> DLi; �d X007 <br /> 19 <br /> F RG4 _[[e�j4` PUBLIC RECORDS RELEASE APPLICATION <br /> A�rc3' ^"l�C�lLmLln Maria Carranz8 BUSINESS/AGENCY: Advanced GeoEnvironmental <br /> ADDRESS: 837 Shaw Road Stockton, CA <br /> PHONE(1): 209 467-1006 PHONE(2): 209 609-4067 FACSIMILE: 209 467 1118 <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-"Tentative only-must be confirmed) <br /> CHECK BOX TO EXPEDITE REQUEST-$98.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT Q DATE <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street Name City `U <br /> _ \ <br /> Street# _ - El Unit 1 <br /> 1. 20921 South Austin Road Manteca <br /> 2, 9909 East Woodward Manteca �/ �0 Unit <br /> 3. <br /> lC � ik' Yr�rzz! �yrr,n Ltd 1 ?CY <br /> 4. nit 3 <br /> d. I <br /> 7. <br /> -- - <br /> 8. - -- Unit 5 <br /> 9. — <br /> . Unit 6 <br /> 10. <br /> Specific Date Rang" <br /> rmat!on Requested: From to <br /> ENVIRONMENTAL HEALTH DEPART ENT FILES <br /> )VUNDERGROVND TANK(UST)CLEANUP SITE(LOP) Cl Hovsma ABATEMENT $OLID WASTE FACILIIYNEHICLE <br /> 9PYHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> UNDERGROUND TANK(MON ITORINGIREMOVAL) Q Doo KENNEL DAIRY <br /> HAZARDOUS WASTE GENERATOR In CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> O TIERED PERMITTED FACILITY ❑MOTEL(HOTEL ❑ PUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑TATTOOIBODY PIERCING 0 POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑MEDICAL WASTE FACILITY ❑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 list 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 after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant If any END 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 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$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> END 48-OB WE6 8/812007 <br />