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03/18/2015 12 : 26:51 PM 04 0 FAXCOM ANYWHERE PAGE 2 OF 2 <br /> S <br /> DATE RECEIVED di EHD LOG NUMBER ` <br /> gyp^" ® SAN JOAQUIN COUNTY <br /> [� <br /> M: iE "—��� <br /> 1868 East OHazellton Avenue, Stockton, CA 95205-6232 O� <br /> NARIS Z�jTplephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> Y PUBLIC RECORDS RELEASE APPLICATION <br /> I.N 8ffiA�Y Rennah <br /> APPLVYFA�VjBUSINESS/AGENCY: PM Environmental <br /> ADDRESS: 4401 Atlantic Avenue,Suite 220 CITY/STATE/ZIP: Long Beach, Ca 90807 <br /> PHONE(1): 714-348-2743 PHONE (2): kennah Dpnnenv.com FACSIMILE: 877-884-6775 <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> ❑ CHECK BOX TO EXPEDITE X <br /> REQUEST-$130 F'/EE(CASHORCHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT t'& �,�,�,,,�,K o�__9 , DATE 3/17/2015 <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name city ❑Unit 1 <br /> 1• 23623 South Bird Road Tracy <br /> 2. 23763 South Bird Road Tracy UFr ❑Unit <br /> 3. <br /> 4. 0-61t 3 3 1 <br /> 5. 1 <br /> �tvv'wAe� ,3 e5. <br /> s. ❑,uta <br /> 7. 2 <br /> 8. J �O ❑Unit5 <br /> 9. <br /> 10. ❑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 FACILITYNEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> xj UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ®ABOVEGROUND TANK ❑CHICKEN RANCHI DOG KENNEL ❑WAST-WATER TREATMENT PLANT <br /> ®HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICALTOILETS <br /> ©TIERED PERMrrrE'D FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00AM-6:00PM(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.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted above. <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 filL�not returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant. <br /> Future file reviews bythe same applicant may require a$130 deposit prior to review. 'BOXED AREA-EHD USE ONLY"" <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> R7e'lved Time Mar. 18. 2015 9:26AM No. 8354 08101N4 <br />