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From: LEIV xu To. Fax: (209)464-0138 Page 2 or 2 08/16/2017 12:08 PM <br /> DARE SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> /4Cl(i G ZOt1 14 ENVIRONMENTAL HEALTH DEPARTMENT ?Gq27 <br /> 14t0 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �� ���� Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> AM pERMIT15EEtu!%^a Ott PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Leigh Cloven BUSINESS/AGENCY: Pinnacle Environmental Inc. <br /> ADDRESS: 102 Ave. San Dimas, Unit B CITY/STATE/ZIP:San Clemente, CA 92672 <br /> PHONE (1): 949)302-4404 PHONE (2):Fax 866)845-4954 FAX OR E-MAIL: lei hg_@pei-env.com <br /> Please allow 19 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-$139 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE August 16, 2017 <br /> 1. List un to ten addresses in the space below. Select the type(s)of files from the list below 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 $139 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From 01/01/1900 to 8/16/2017 <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESSFILES I EHD USE ONLY <br /> UNDERGROUND TANK(UST) Street# Street Name City <br /> foCLEANUP SITE(LOP) ❑11111MER <br /> OTHER CLEANUP SHE(NONL ' 1.756 N. Wilson Way Stockton <br /> tX HAZARDOUS WASTE DARY <br /> TIERED PERMITTED FACILITY 2 <br /> (NABDVEGROUND TANK <br /> Id UST (MONITORING)REMOVAL) []PWS <br /> lA HAZARDOUS MATERIALS 3 <br /> [XSPWIRELEASE RESPONSE <br /> DDumf <br /> N SOLID WASTE FACILITY I VEHICLE JATFR <br /> 4 <br /> FOOD FACILITY <br /> POOL ISPs 1rtE1MIRGATION <br /> ❑DNRY 6 <br /> ❑T LAND USE APPUCATIDN SITES �• <br /> U SEPTIC PUMPER TRUCK I ❑HOW INC <br /> 6 <br /> V+RD/CHEMIO.+L TOILETS <br /> WASTEWATER TREATMENT PLANT CUPA <br /> FIVJSING ABATEMENT 7 <br /> ❑MOTELIHOTEL <br /> CHICKEN RANCH/Doe KENNEL COPA-UST <br /> MEDICAL WASTE FACILITY 9 <br /> TATTOOIBODY PIERCING <br /> WASTE TIRE 60EOUO WASTE <br /> 9 <br /> CDMPLPINT <br /> F1 OTHER(PLEASE SPECIFY): 0 AcmumNG <br /> 10 <br /> "'BOXED AREA-EHD USE ONLY— <br /> �3116/t� - C • Ea co.-1 <br /> 0 Records provided by Staff-PPR Complete. staff Name: <br /> Received Time—Aug, 16. -201 /-12; 03PNrNo. 2111 <br />