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11/08/2016 4 : 30 : 33 PM —0500 FAXCOM ANYWHERE PAGE 3 OF 3 <br /> DAyrQ�WF,Pj,.��r EHD LOG NUMBER <br /> KK ((�V/I''�}LY.rr1</r+..+ SAN .IOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT 8�5oluNOV K, Oft$ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> RMAOINMENITAL,PERMfT CI THPUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Amanda Benbow BUSINESS/AGENCY: PM Environmental <br /> ADDRESS: 3400 Douglas Blvd Suite 200 CITY/STATE/ZIP: Roseville, CA 95661 <br /> PHONE (1): (916) 472-2870 PHONE (2): 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 EXPEDITEUEST $ 30 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT( � DATE 11/8/2016 <br /> Electronic Information: ❑ List ❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> jY reef# Street Name Clly []Unit 1 <br /> rl. l <br /> 1789 West Charter Way Stockton 4f/ <br /> 1817 South Fresno Ave Stockton R/ <br /> Ly Unit2 <br /> 3 <br /> 4• dUnit 3 <br /> 5. <br /> Ung# <br /> 6. (� <br /> 7. <br /> 8. ❑ Unit 5 <br /> 9. (� �,p AI <br /> 10. )1) �w1 <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 /> ®UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ®ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> ®HAZARDOUS WASTFJHAZARDOUS MATERIALS ❑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 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.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 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$130 deposit prior to review. `BOXED AREA- EHD USE ONLY*** <br /> 0 I v 1 <br /> W <br /> C ��s10, <br /> ❑ Records provided by Staff-PPR Complete. Staff name: LAM L W, I 222C <br /> R7e'ived Time Nov. 8, 2016 1 : 27PM No. 0315 08101114 <br />