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/ DATE D EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> 0 0 2011 ENVIRONMENTAL HEALTH DEPARTMENT <br /> f�0 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: vvwv✓.sjgov.org/ehd <br /> ENVIRONMENTAL HEALTH Vk <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Kerran Pender BUSINESS/AGENCY: Partner Engineering and Science <br /> ADDRESS: <br /> 400 Second Street Suite 415 City/State/Zip San Francisco, CA <br /> --- --_--_---_-- _---- ----_---_— <br /> 415 962-4755 917-710-2770 1-800-419-4923 <br /> PHONE(11� ---------------- PHONE 12)� -------------- —FACSIMILE: ------------- <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-$105 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT Kerran Pende7 DATE 8/29/11 <br /> Electronic Information: ❑ List ❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City <br /> 1. 2680 Auto Plaza Way Tracy I Q Unit1 <br /> 2. 3450 Auto Plaza Drive Tracy I ��5f d cy5X Unit 2 <br /> 3. <br /> 4 Unit 3 <br /> 5. �r <br /> 6. - unit 4 <br /> - -- - El 5 <br /> 8. <br /> 9. <br /> Unit 6 <br /> 10. <br /> Specific Date Range of Information Requested: From _ to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT SOLID WASTE FACILITY/VEHICLE �7- <br /> OTHER CLEANUP SITE(NON-LOP) 171 FOOD FACILITY WASTE TIRE I ./ <br /> JZ UNDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL ❑DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH 32rWASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY 11 MOTELIHOTEL 0 PUMPER TRUCK/YARD/CHEM TOILETS <br /> In TATTOO/BODY PIERCING ❑ POOL/SPA LAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY ❑OTHER(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 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 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 $105 deposit prior to review. <br /> EHD USE ONLY <br /> �(Q $ � ) <br /> EHD 48-06 8/04/08 PUBLIC RECORDS RELEASE APP FORM <br />