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REGENED • 0 EHD LOO NUMBER <br /> LLL���VLL.. SAN .IOAQUIN COUNTY 1 <br /> MAH 26 2012 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Sau San BUSINESS/AGENCY: Partner Engineering & Science <br /> ADDRESS: 400 2nd Street, Suite 415 CITY/STATE/ZIP:San Francisco, CA 94107 <br /> PHONE (1): 415-373-6317 PHONE(2): FACSIMILE:415-889-6020 <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 R - 122 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 3/26/12 <br /> Electronic information: ❑ List ap-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street d Street Name City <br /> ✓A".l 1. 2650 North MacArthur Blvd Tracy _ E3 unit, <br /> SI N© <br /> 5T k�tAl 5 ref <br /> z. <br /> UnIt2 <br /> 3. — <br /> 4. <br /> Unit 3 <br /> S. <br /> Unit 4 <br /> 7. <br /> 0' ❑Unit S <br /> 9. <br /> 10. <br /> Unit 51 <br /> Specific Date Range of Information Requested: From All to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> t <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT SOLID WASTE FACILITYNEHICLEZ <br /> THER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY WASTE TIRE 3 1`'1 <br /> NDERGROUND TANK(MONITORING/REMOVAL) � ❑DOG KENNEL DAIRY UA 1-4-3. <br /> 3' ,G <br /> AZARDOUS WASTE GENERATOR �,/.J,' CHICKEN RANCH WASTEWATER TREATMENT PLANTIERED PERMITTED FACILITY 4- ❑MOTELIHOTEL PUMPER TRUCKNARD/CHEMICAL TOILETS <br /> ATTOWBODY PIERCING ❑POOL/SPA LANG USE APPLICATION SITES <br /> .MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 6:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List un to ten addresses in the space above. Select the types)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 EHD files exist. An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The files will be held fora 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$122 deposit prior to review. <br /> EHD USE ONLY <br /> - - z <br /> EHD 4"6 07/29/10 <br />