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RECEIVED <br /> SAN J OAQ U 1 N JUIN 0 4 2038 Environmental Health Department <br /> - C OU N TY------- PUPLIC RECORDS RELEASE APPLICATION <br /> F.b�Vlb�?M11WX;rAL 11-11PPM (ZOO <br /> • PEnwri mAtEs �- AN1 EHD LOG NUMBER: �! 'V l af• V <br /> APPLICANT: Bailey BalShor BUSINESS/AGENCY: Partner Engineering and Science, Inc <br /> ADDRESS: 1544 Eureka Road, Suite 180 CITY/STATE/ZIP: Roseville, CA 95661 <br /> PHONE(1): 916-823-7555 PHONE(2): FAX OR E-MAIL: BBalshor(d_)partneresi.Com <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact,yov to afrange an appointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT I )�/ IidT ���ir f 40 DATE 5-31-2018 <br /> 1. List up to ten addresses in the space below. Address ranges WILL NOT be accepted. Select the type(s)of files from the <br /> list below by checking the appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138,mail to the <br /> address indicated below, or email to info(cDslcehd.com. Applications received after 3:00 pm will be processed the next <br /> business day. <br /> 2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted below. <br /> 3. 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 /> 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$152 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS AL" <br /> ( p Y 9 accepted) EHD USE ONLY <br /> FILES (Specific addresses only, address ranges will not be acce ted <br /> ❑X Underground Tank(UST) Street# Street Name city <br /> X Cleanup Site(LOP) 5 I11y2 QO�❑CONSUMER <br /> ®Other Cleanup Site(Non-LOP) ' 1422 West Colony Road Ripon 11M PRpo, �-may _Wh_(�A <br /> • ®Hazardous Waste I"� /,j-�6N��M ❑DAIRY <br /> ®Tiered Permitted Facility � 2 1442 West Colony Road Ripon _ 1, <br /> Q Aboveground Tank F{p�.,111 f,t15 19im Wrj+R-y <br /> ®UST (Monitoring/Removal) ❑PWS <br /> ®Hazardous Materials 3 <br /> ®Spill/Release Response <br /> Solid Waste Facility/Vehicle 4 WATER QUALITY <br /> ❑Food Facility <br /> F]Pool/Spa SITE MITIGATION <br /> R Dairy 5 <br /> r] Land Use Application Sites <br /> Septic Pumper Truck/ ❑6 HOUSING <br /> Yard/Chemical Toilets <br /> F]Wastewater Treatment Plant (CUIA <br /> R Housing Abatement 7 AST I HM/HW <br /> ❑Motel/Hotel <br /> F1 Chicken Ranch/Dog Kennel gGLIPA <br /> Medical Waste Facility 8 UST <br /> Tattoo/Body Piercing <br /> ❑ <br /> Waste Tire SOLID WASTE <br /> s <br /> Fj Complaint <br /> Other(Please Specify): ❑ACCOUNTING <br /> 10 <br /> ***BOXED AREA-EHD USE ONLY— <br /> " C+` t%e Ing;v2 -t <br /> n l <br /> 71 f <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: EHD 48-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209464-0138 1 www.sjcehd.com <br />