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DATE RECEIVED SAN JOAQUIN COUNTY 0 <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />EHD LOG NUMBER <br />QJ PUBLIC RECORDS RELEASE APPLICATION p <br />APPLICANT: JKristen Rini BUSINESS/AGENCY: IPM Environmental <br />ADDRESS: 13400 Douglas Boulevard, Suite 200 CITY/STATE/ZIP: Roseville, CA 95661 <br />PHONE (1): (916) 945-3778 PHONE (.2.):1(330) 221-3440 1 FACSIMILE: <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 REQUEST - $125 FEE (CASH OR CHECK ONLY) -REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT Kristen Rini DATE 5!14/2014 <br />Electronic information: ❑ List ❑ Map —Description: <br />FILE ADDRESS <br />EHD USE ONLY <br />El Unit 1 <br />Street /t <br />Street Name <br />City <br />1. <br />1415 <br />est Anderson Street <br />Stockton <br />A9 I M Gorr p <br />A HMAW w T N�Ow © Unit 2 <br />2. <br />ISouth Pershing Avenue <br />1443 <br />Navy Drive <br />�}w `Fl HC`'6r .Rcitll'Ox <br />1 Li Unita <br />4 <br />1505 <br />Navy Drive <br />5. <br />1111 <br />Na Drive <br />�e HM V sT(w �'l � ccsp <br />l l] Unit4 <br />S. <br />7. <br />❑ Unit 5 <br />8. <br />( `� <br />,� <br />9. <br />nit 6 <br />10. <br />Specific Date Range of Information Requested: From <br />,.._/ ENVIRONO <br />[ UNDERGROUND TANK (UST) CLEANUP SITE (LOP) <br />�G/0THER CLEANUP SITE (NON -LOP) <br />Ly UNDERGROUND TANK (MONITORINGIREMOVAL) <br />BOVEGROUND TANK <br />LVrt[AZARDOUS WASTEIHAZARDOUS MATERIALS <br />LVtIERED PERMITTED FACILITY <br />❑ TATToOIBODY PIERCING <br />MEDICAL WASTE FACILITY <br />HOUSING ABATEMENT <br />FOOD FACILITY <br />CHICKEN RANCH] DOG KENNEL <br />MOTELIHOTEL <br />RECORDS <br />to (Present I <br />iOLID WASTE FACIUTYNEHICLE 11� J�1��1�e5 <br />NASTE TIRE I C <br />�1aIRY µl:5 c6 <br />AN(34 <br />STEWATER TREATMENT PLANT L Yay' <br />�dMPER TRUCKIYARDICHEMICAL TOILETS <br />NO USE APPLICATION SITES <br />JTHER (PLEASE SPECIFY) Any records of <br />WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:OOPIyi <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 $125 deposit prior to review. `BOXED AREA - EHD USE ONLY*" <br />Pra+',ci6�yb�.wlness o�ArJl loPanaiLn ID d Cham wle.+l ITsf For 1.115 A�xlerscn. (Jc-Tnick�Ay £ Pa:+f'tm �ba/c- /o +s}y�g�+`�� fy <br />LV14mo, expre-,Q) 155Sntuoy(+VIgc+Y/IUAIpz}/elcuM/Groans! pehnlew y. Illi tJa�B(�oslNPvrRkyForvls), PrDvlcloEt eD Fed <br />14157 Ande�uA 4, T, Pa�n&en T -/S Una Pc:J. letbi Mr IIY'S 1IAv9(b o,N - ,pe+) RDV1� 11�R�Ct.+QRf�il7i leti'F Jd EiTUckS.�c i5i3S �4 <br />._ "M 11144A <br />Pra+',ci6�yb�.wlness o�ArJl loPanaiLn ID d Cham wle.+l ITsf For 1.115 A�xlerscn. (Jc-Tnick�Ay £ Pa:+f'tm �ba/c- /o +s}y�g�+`�� fy <br />LV14mo, expre-,Q) 155Sntuoy(+VIgc+Y/IUAIpz}/elcuM/Groans! pehnlew y. Illi tJa�B(�oslNPvrRkyForvls), PrDvlcloEt eD Fed <br />14157 Ande�uA 4, T, Pa�n&en T -/S Una Pc:J. letbi Mr IIY'S 1IAv9(b o,N - ,pe+) RDV1� 11�R�Ct.+QRf�il7i leti'F Jd EiTUckS.�c i5i3S �4 <br />