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07/1912012 08:24 Advanced GeoEromental Inc. )209 4671118 P.0011001 <br />�. I V� - SAN JOAQUIN C END LOG NUMBER <br />JUL 19 2012 )ENVIRONMENTAL HEALm DEPARTMENT <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web; www.sjgov.org/ehd <br />IEWRONMENT:AL HE A H <br />PERMIT/SERVICES PLIC RECORDS RELEASE APPLICATION <br />APPLICANT: L 6 � ���`� r��j-� �L �p BUSINESS/AGENCY: C" <br />ADDRESS: �3-2 SUti!1( 7 t (��.-L>7Ts�GU'i'©l/l- — I <br />PHONE (1): I"" i�� PHONE(2): FACSIMILE:b? <br />TENTATIVE" APPOINTMENT DATE: Time: <br />(Please allow 10 business days from date of application submittal - `Tentative only - must be confirmed) <br />13 CHECK BOX TO EXPEDITE REQUEST - $98.00 FEES f�(CffAS�SH OR CHECK ONLY) - REQUEST PROCESSED IN 3 USiNIESS DAYS <br />SIGNATURE OF APPLICANT w A4 0 UUP DATE 'Ii� !� <br />Electronic Information: ❑ List ❑ Map — Description: <br />FILE ADDRESS <br />EHD USE ONLY <br />Street # <br />Street Name <br />city <br />Unit 1 <br />1. <br />g <br />Lam OA.> <br />eIZ41M <br />2. <br />unit 2 <br />A 4f <br />3. <br />Unit 3 <br />- <br />4. <br />�. <br />Unit 4 <br />s. <br />7. <br />Unit 5 <br />8' <br />1191 <br />Unit 6 <br />10. <br />Aq <br />Specific Date Range of information Requested: From to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES '�� <br />171 UNDERGROUND TANK (UST) CLEANUP SITE (LOP) HOUSING ABATEMENT � OLID WASTE FACILiTYIVEHIC <br />�THERCLEANUP SITE (NON -LOP) 0 FOOD FACILITY .r�WASTE TIRE <br />.f NDEROROUND TANK (MONITOk1NG(REMOVAL) 0 Doo KENNEL DAIRY <br />HJV.ARDOUS WASTE GENERATOR n CHICKEN RANCH d WASTEWAT13RTREATMENT PLANT <br />TIERED PERMITTED FACILITY M MOTEUHOTEL 0 PUMPER TPUCKNARD/CHEM TOILETS <br />0 TATTOOIBODY PIERCING 0 POOL/SP A LAND UsF APPLICATION SITES <br />0 MEDICAL WASTE FACILITY ,J2rOTHER 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 wili 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 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 />I *** If You should need further assistance please contact Diane Martinez @ (209)468-3425 directly. Thank You*** <br />Received Time—Jul. 19.-2012— 8:21AM—No,059 <br />