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06/07/2017 5:59 PM 141Sy51y4L1 �i�uytaYuluo <br /> �L �E9 SAN JOAQUIN COUNTY EH©Loa NUMBER <br /> i i {� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 18 <br /> }LN 01 AV ;�LAel�� 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ,rAI_ Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.orgfehd <br /> FWrr>sElWl <br /> EC PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Brian Kim BUSINESS/AGENCY: Partner Engineering & Science, Inc. <br /> ADDRESS: III Pine Street Suite 1750 CITYISTATEIZIP: San Francisco, CA 94111 <br /> PHONE (1): (415) 680-8953 PHONE (2): FAX OR E-MAIL: bl im@partneresi.com <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 /> [] CHEIJtE'B4XTc]EXpI✓k 1TE f�EQUeST 51301 EE;j0ASH-,Q FH C'K OtILY)LY)-':RPRC7GESSEL?;fN 3 8L(SINESS 150§ j l <br /> SIGNATURE OF APPLICANT DATE June 7, 2017 t <br /> Electronic information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EH 9 ONLY <br /> Street# Street Name City <br /> 1 1021 E Hazelton Avenue Stockton <br /> 2. 1023Stockton <br /> l✓Hazelton Avenue <br /> 3` 1025 E Hazelton Avenue Stocktond-��r <br /> 4. 1020 E Church Street Stockton 14 <br /> 5' PA <br /> 1.022 E Church Street Stockton <br /> MCA'° <br /> 6_ 1021 E Church Street Stockton do�� h'A1 <br /> 7. l 026 ll,� i l,v►•te,.k <br /> E Church Street Stockton ,� <br /> g' 1028 E Church Street Stockton SITE MITIGATION <br /> 1030 E Church Street Stockton <br /> Specific Date Range of Information Requested, From All to <br /> ENVIRONME TAL HEALTH`D.EPARTMENT;Fjt_ES <br /> FXJ UNDERGROUND TANK(UST)CLEANUP SITE(LOP) L^l MOTELIHOTEL E]SOLID WASTE FACILITYIVEHICLE <br /> Q OTHER CLEANUP SITE(NON-LOP) FXJ HOUSING ABATEMENT X❑FOOD FACILITY <br /> XX UNDERGROUND TANK(MONITORINGrREMOVAL) Q WASTE TIRE DAIRY,POOLISPA <br /> 0I ABOVEGROUND TANK CHICKEN RANCHI DOG KENNEL X❑WASTEWATER TREATMENT PLANT <br /> _i <br /> I HAZARDOUS WASTE Q MEDICAL WASTE FACILITY PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> 0 HAZARDOUS MATERIALS ®� TATTOOIBODY PIERCING LAND USE APPLICATION SITES <br /> Ej TIERED PERMITTED FACILITY E]COMPLAINTIRESPONSE RECORDS Q 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 u- p 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(2091464-0138 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. <br /> **'BOXED AREA-EHD USE ONLY <br /> l 4 l <br /> M 0___". .�r....:.+...t Ia.. er-lfs_nno r, .....i.,s� Staff Name: <br /> Received Tlme=Jun. 7. =2017= � . 5P11r°Na, 1b47 <br />