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-v-:`- r:: .<:<::::__: __.._ _ <br /> ------ PAGE PAGE 2 OF 2 <br /> 05/09/2016 6 :28:41 PM —0400 FAXCOM ANYWHERE <br /> � EHD LOG NUMBER <br /> D CEiVE SAN JOAQUIN COUNTY I <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1�rhY 12016 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> 1 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: v,nvw.sjgov.org/ehd <br /> q 3:a:TNIARONMEfdTAL HE&Tkl <br /> e••`,' PE 'TlS <br /> ERrricES "-' p(}gLtC RECORDS RELEASE APPLICATION <br /> APPLICANT: Amanda Benbow benbow@pmenv.com BUSINESS/AGENCY: PM Environmental Inc. <br /> ADDRESS- 3400 Douglas Blvd Suite 200 CITYISTATE/Zi P: Roseville,CA 95661 <br /> PHONE(1): (916)472-2870 PHONE(2): 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 EXPEDITEE UEST 0 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANTMA _ DATE <br /> Electronic information: [List❑ Map—Description: <br /> -- FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City Un 1 <br /> 1. 1115 West Yosemite Ave Manteca }�T � �,i( <br /> 2. 1145 West Yosemite Ave Manteca /1'y y � Unit 2 bh�Ie <br /> y. J 1048 West Yosemite Ave Manteca A13&A e,+ LLlI i �l U <br /> 4. 1060 West Yosemite Ave ji 01 CIF6 Manteca 0 NO Ir E'Unit3 <br /> 5. 1257 West Yosemite Ave Manteca r✓J fA/5 <br /> 6. 1160 West Center Street Manteca A)O / P ntt � <br /> TW.F7. <br /> 8. ❑unit 5 <br /> S. ye3+21t �fhl� <br /> 10. Q unit-@- <br /> Specific Date Range of Irdormatlon Requested: From earliest available to present <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ©UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACIL7EHICLL <br /> MOTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE T FTt ,`�fj 5 <br /> XJ UNDERGROUND TANK(MONITORINGIREMOVAL) E]FOOD FACILITY ❑DAIRY �,I'I 17 + <br /> ®ABOVEGROUND TANK El CHICKEN RANCHI DOG KENNEL [:]WASTEWATER TREATME PLANT(�J•I3'I `+' <br /> ®HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICALTOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOLISPA Q LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑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 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$130 deposit prior to review. *"BOXED AREA-EHD USE ONLY"` <br /> c <br /> yod <br /> Ye <br /> fi 1 <br /> Received Time May 2016 3: 7PM No. O 85 F07 '1145- ��iYI,t}g. v 13 Ib rad U3f°{n`S o- <br /> (lem� �GA`bbl26h- kM� Vco'Iz5-7�osPi7ide. ? 10-13Ila OwJusf#4r#s (o <br />