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DATE RECEIVED SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL 141�ALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 69 <br /> J (U` Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehdq <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Terry Nephew tnephew@kleinfelder.com BUSINESS/AGENCY:Kleinfelder <br /> ADDRESS: 5125 N. Gates Ave., Ste 102 CITY/STATE/ZIP: Fresno, CA 93722 <br /> PHONE (1): 559-577-1459 PHONE (2):559-647-3842 FACSIMILE:559442-5081 <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-$1A25 FEE GASH R CH CK,ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT N Ff DATE <br /> Electronic Information: ❑ List❑ Map L Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name city _ 1 <br /> 1. 400 East Main St. Stockton M <br /> 2. 47 South San Joaquin St. Stockton /VI ❑ Unit 2 <br /> 3. 236 East Miner Ave. Stockton /Joll4'i3 No tot�J <br /> 4. 700 East Market St. Stockton t4 PA <br /> M J [A-'Unit 3 � <br /> 5. 400 South Aurora Stockton ug f0()/(0(� w D <br /> 6. 521 East Main Stockton p A9 LOr P c O p-Onit 4 I/a <br /> 632 South EI Dorado Street Stockton _ p� ® �- <br /> V f U 1 t0 <br /> 8. 423 North Madison Stockton o - aQ l r ❑ Units <br /> 9. 402 West Weber Ave Stockton Uy 7C>7) p o 00/5P <br /> 10. 40 Lincoln Street usore fi 0 L0(_,/ ❑ unit s <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FAC!IL'ITYIVEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE"Jqr1 lP 5 ('fir r <br /> ®UNDERGROUND TANK(MONITORINGIREMOVAL)V, ❑FOOD FACILITY ❑DAIRY t GJ Ct& 10- 7'1� <br /> ®ABOVEGROUND TANK 4_ ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> ®HAZARDOUS WASTEIHAZARDOUS MATERWLSpL ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOLISPA - ❑LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PE —/9D k A'1--e -- (Digo py Oc(75�ri9t 5106 �n tfuf,I B . (CLUDING HOLIDAYS) <br /> 1. List up to ten addr Mai/) 5,s '�II. -7/ZY/Dq OI K) a-t,D OQ&Lt((/ theappropriate <br /> IIOD lA(:03. 713 Provo O Pri ! <br /> box(es). At least< NA'L,POP 5, re ee7(7i {-turn de" L4P) 1 n U`�'r�r� ad above. Address <br /> ranges <br /> e will not be U� A(0rct_ Co 3530 J.((Q) S to&)°L co 00 35305(1-p-51Db a ons received after <br /> O <br /> Pm to/Ito/ggD1e-)0ACDlfurncdow file,. <br /> 2. The EHD will notif (� 5i06 OA-&;,l Ipproximately ten(10) <br /> days after receipt (73J 610, rvdO- U��24 B `�5i�)d 0039 5- 1C <br /> 14o 1� Ftle For Plea 9IL4L4IS. tp�03J 57�roPhS d Y) �. Appointments <br /> should be schedu / <br /> 60 0036(ob] f 510 ° 3/zo 01�� ,Iw application may be <br /> 3. A file that is active d P / �. PP Y <br /> submitted whentl F�c (pr PRO2 D1'3• COIPII/flIP� <br /> 4. Any file not returr t♦�0 MacUsOn- (ofAa05�gtrpFSl06) /1 �'^ ?�'C�Q se of the applicant. <br /> Future file review: T f;fe• icant may require a$125 deposit prior to review. —BOXED AREA-EHD USE ONLY*"* <br /> ri3 <br /> 0 a n _010- . 11', ro s1) <br /> 1 I o o- 5 zo- Ur& ­_.k� {�r 4� stn ext ,urn <br /> ��v; SOP �v1+ quI u�cuwral� lzl IP r ua !/! Fr/� Is Pro 0 oa& o <br /> �x�carasTEravraea uq 5ran ete-starc,vame:U, <br /> Fun ea.na 12119112 <br />