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'!9 16 09:11 a Nelson Environmental 775-254-3748 <br />P.1 <br />f A DATE RECEIVED - %ofSAN JOAQUIN OUNTY EHD LOG NUMBER <br />RECEIVE® ENVIDn �EKiTA EAL� E 1868 EaSt Hazelton Avenue, Stockton, CA E�( <br />05-6232 <br />JAN 2 9 2+ lephone: (209) 468-3420 Fax: (209) 464-0138 Web: 52www.s gov.org/ehd <br />€ ' €€ RVITS MACM Ili PUBLIC RECORDS RELEASE APPLICATION <br />o9PN r���• Hen <br />APPLICANT: Mike Nelson BUSINESS/AGENCY: Nelson Enviro LLC <br />ADDRESS: 103 Laurel Ave. CITY/STATE/ZIP.-Atwater, CA 95301 <br />PHONE(i): 209-769-7460 PHONE' <br />FAX ORE -MAIL: mike@nelsonenviro. <br />Pfe a allow business days from date of application submittal for the records to be available. corn <br />Staff will contact you to arrange an a pointm �tdate and time to review the requested records. <br />❑ CHECK BOX TO EXPEDITE REQUE 0 E H R CHE <br />-l.. REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT DATE 1/29/2016 <br />Electronic Information: ❑ List ❑Map-Descnotion, <br />Street* Street Name <br />city <br />EHD USE ONLY <br />1- 729 E. Market St. <br />Stockton GUS <br />2• 700 E. Market ST. <br />• ;U0 <br />Stockton��5f <br />❑Unlet <br />G 3. 742 E. Main St. <br />Stockton <br />/ <br />4. 2021cop <br />E_ Miner Ave_ <br />Stockton <br />tib Unit ' <br />❑ <br />$. <br />• • • )UD <br />[I Unit 2H <br />( 6. <br />Dwninit a <br />7• <br />CVWnit 3HM <br />6, <br />nit 4 <br />g. <br />0'9iTE MITIGATION <br />70. <br />❑ Unit 5 <br />5Pec15c Dale Rengeof Udumlahw Requested; From <br />ENVIRONMENTAL HEALTH DEPART& ENT FILES <br />® UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑MOTELMOTEL�L�(� <br />El OTHER <br />to <br />❑ SOLID <br />CLEANUP SITE (NON -LOP) <br />UNDERGROUND TANK (MOMTORINGIRENOVAL)O <br />❑HOUSING ABATEMENT <br />❑ WASTE TIRE <br />WASTE FAC4.i'IPT(/EHI E <br />❑ FOOD FACILITY <br />Q ABOVEGROUND TANK � <br />® HAZARDOUS WASTE^ <br />❑ CHICKEN RANCH/ DOG KENNEL <br />❑DAIRY, POOLISPA O. <br />❑WASTEWATER TREATMENT PLANT <br />® HAZARDOUS MATERIALS <br />❑ MEDICAL WASTE FACILITY <br />❑ TATTOOIBODY PIERCMG <br />El PUMPER TRUCKIYARD/CHEMK:AL TOILETS <br />1:3 TIERED PERMITTED FACIUTY <br />❑ COMPLAINT/RESPONSE RECORDS <br />❑ LAND USE APPLICATION SITES <br />El OTHER (PLEASE SPECIFY) <br />WELL ANn SEPTIC PFPFIT Dcrnenr ..... �,..... <br />_. <br />1. List uo to ten addresses in the space above. Select the _ "crm `A` LUVIm; HOLIDAYS <br />box(es). At least one <br />lie <br />type MUST be selected. Fax to�Y081)g64-Ot38 or mann to the�address indicated abchecking the oVeropriate <br />ranges will not be accepted. Applications received after 3.D0 pm will be processed the next business day. Address <br />2. For is <br />in identifying the nature and content of FaiD records, please contact EHD at the number noted above. <br />3. The EHD will <br />notify the applicant if any EHD tiles 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 flue 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 sfaff at the expense of the applicant <br />Future file reviews by the same applicant may require a $130 deposit prior to review. <br />