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RECEIVED <br />AN A Q l� N Environmental Health Department <br />I F <br />COUNTY "WIN 18 2018 PUBLIC RECORDS RELEASE APPLICATION <br />hi,�,11I1RO AL�#C, �� <br />• PI MITISM4 s ..�I�A EHD LOG NUMBER: <br />A(x� CtPPLICANT: <br />APPLICANT: Jane Xiao BUSINESS/AGENCY: Partner Engineering and Science, Inc. <br />ADDRESS: 111 Pine Street, Suite 1750 CITY/STATE/ZIP: San Francisco, CA 94111 <br />• <br />AOL <br />PHONE (1): 415-934-9043 ext. 3357 PHONE (2): 628-233-7258 FAX OR E-MAIL: jxiao@partneresi.com <br />Please allow 10 business days from date of application submittal for the records to be available. <br />Staff will contact yotoarrange an appointment date and time to review the requested records. <br />SIGNATURE OF APPLICANT `` A,tac DATE June 14, 2018 <br />1. List up to ten addresses in these, ace 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 a-)slcehd.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 />FILE ADDRESS <br />ALco :TIipI13 <br />HEALTH DEPARTMENT <br />FILES <br />(Specific addresses <br />(p <br />onlyaddress ran es will not <br />y 9 <br />be acce ted <br />p ) <br />EHD USE ONL <br />® Underground Tank (UST) <br />Street # <br />Street Name <br />City <br />;iv" ^57,(: <br />P�� —��� ❑ CONSUMER <br />Cleanup Site (LOP) <br />® Other Cleanup Site (Non -LOP) <br />1 <br />5606 <br />Pacific Avenue <br />Stockton <br />Cono�ty�-ly — 5►b�e Rar <br />Hazardous Waste <br />c�N„y N� L� <br />t <br />E] DAIRY <br />® Tiered Permitted Facility <br />2 <br />5756 <br />Pacific Avenue <br />Stockton <br />� <br />W`b(e 0-7-- 5kULe "T- <br />TUST <br />® Aboveground Tank <br />PA0y -).00 _G`� I{jr`�—(1� ✓ <br />❑ PWS <br />UST(Monitoring / Removal) <br />® Hazardous Materials <br />3 <br />P �����Ot L� � <br />�1 <br />® Spill /Release Response <br />AAwTLj1wj�%_ k�_(n <br />�J f 1(A <br />ATERQUALITY <br />® Solid Waste Facility / Vehicle <br />4 <br />(K�% <br />�5 _1(A — �r _"� • <br />Food Facility <br />,W <br />� �1 ��G�` � W ATV' <br />7J _1 , \♦ <br />SITE MITIGATION <br />F] Pool / Spa <br />❑ Dairy <br />6 <br />® Land Use Application Sites <br />HOUSING <br />Septic Pumper Truck / <br />6 <br />Yard / Chemical Toilets <br />FX Wastewater Treatment Plant <br />CUPA <br />❑ Housing Abatement <br />7 <br />AST / HM / HW <br />❑ Motel/Hotel <br />CUPA <br />F] Chicken Ranch / Dog Kennel <br />g <br />UST <br />❑ Medical Waste Facility <br />Tattoo/Body Piercing <br />E2rSOLID WASTE <br />® Waste Tire <br />9 <br />® Complaint <br />❑ AccOUNTING <br />D Other (Please Specify): <br />10 <br />'*`BOXED AREA - EHD USE ONLY <br />"Ar vv L <br />-4 Aa 6IL99 41- CCCAIICI)0�13t:#t, 00`l <br />O� °I <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 209 464-0138 1 www.sjcehd.com <br />