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RECEIVED <br /> S A N J 0 A 0 U I N (40 14. 2iJb� Environmental Health Department <br /> C:0 U !�TY ---- PUBLIP RECORDS RELEASE APPLICATION <br /> awc) <br /> • r�cfNpal <br /> i =SlAawym <br /> IL EHD LOG NUMBER: � ��•/ <br /> APPLICANT: Corinne Kennah-Cohn BUSINESS/AGENCY:Partner Engineering&Science Inc. <br /> ADDRESS: 1544 Eureka Road,Ste 180 CITY/STATE/ZIP:Roseville,CA 95661 <br /> PHONE(1): 714-348-2743 PHONE(2): FAX OR E-MAIL: ckennahcohn@partneresi.com <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contacto to arrange appointor t date and time to review the requested records. <br /> SIGNATURE OF APPLICANT DATE 5.;1412018 <br /> 1. List up to ten addresses in the s-15ace 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)sicehd.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. "1 <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) f, <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT y g accepted) EHD USE ONLY <br /> FILES (Specific addresses only,address ranges will not be acce ted <br /> ❑X Underground Tank(UST) Street# Street Name city <br /> Cleanup Site(LOP) t-F�` y,yi�j P El CONSUMER <br /> Q Other Cleanup Site(Non-LO 1 2020 E. Grant Line Road Tracy ^I' n n <br /> Q Hazardous Waste <br /> DAIRY <br /> Q Tiered Permitted Facility 2 <br /> Q Aboveground Tank kw.Kh w <br /> FX UST (Monitoring/Removal) ❑PWS <br /> Q Hazardous Materials 3 <br /> Q Spill/Release Response <br /> WATER QUALITY <br /> Q Solid Waste Facility I Vehicle q <br /> F]Food Facility <br /> Pool I Spa ITE MITIGATION <br /> Dairy 5 <br /> F]Land Use Application Sites <br /> HOUSING <br /> Septic Pumper Truck/ e <br /> Yard I Chemical Toilets <br /> Wastewater Treatment Plant CUPA <br /> Housing Abatement 7 AST I HM/HW <br /> ❑Motel/Hotel <br /> F1 Chicken Ranch I Dog Kennel CUPA <br /> Medical Waste Facility 8 UST <br /> Tattoo/Body Piercing SOLID WASTE <br /> F1 Waste Tire g <br /> Q Complaint <br /> Other(Please Specify): ❑AccouNTING <br /> 10 <br /> ***BOXED AREA-EHD USE ONLY*** f_ _ <br /> -`^4 n\t��� �,/1�9 iJ <br /> cG �.l Ln" v46Z`"U1vZ I n ovval <br /> Oq <br /> o-0 r,ou <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: EHD 48-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />