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DATE RECEIVED EHD LOG NUMBER <br /> SAN .IOAQUIN COUNTY . <br /> DEPARTMENT <br /> ENVIRONMENTAL <br /> 1868 East aon Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: v✓ww.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION ' <br /> f <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):1330)221-3440 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 E] Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑Unit 1 <br /> 1. 1415 est Anderson Street Stockton q I M raomsp <br /> r <br /> p Unit 2 <br /> 2. 820 South Pershing Avenue q yµnW w r NcwSP <br /> 1443 Navy Drive `Fl dt P.r-g>r <br /> 4 1505 Navy Drive MM vi unit3 <br /> 5. 1111 Na Drve "'P ,^ <br /> f <br /> 6. l .,Y Unit4 d` <br /> 7. 1j <br /> 8. i1`I' ,] ❑Units <br /> 9. <br /> 10, it 6 <br /> s <br /> Specific Date Range of Information Requested: From 1900 to ,Present <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES r" <br /> VWUNDERGROUND TANK(UST)CLEANUP SITE(LOP) L�MEDICAL WASTE FACILITY OLID WASTE FACILITYIVEHICLE 11�Tl�25 <br /> [OTHER CLEANUP SITE(NON-LOP) 1-1 HOUSING ABATEMENT ASTETIRE ,f <br /> &GNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑ IRY UAk C� 14 <br /> ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL STEWATER TREATMENT PLANT ) b•T.1° � <br /> OOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL WeWMPER TRUCK/YARDICHEMICAL TOILETS <br /> LAd'TIERED PERMITTED FACILITY ❑IOOLISPA ND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING OMPLAINTIRESPONSE RECORDS THE (PLEASE SPECIFY) ny records of <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:( PM(EXCLUDING environmental <br /> concern <br /> 1. List un 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 /> C' 1,2' 11 I ) 3 S53 �r }5 CD N61 <br /> 19 (9(a r 510 ' la o e F- cph rC,r3b00*�L0-1j <br /> r`�._: IR-xt:toh XraJ-Ob XSJ't510 1445 i4qutA <br /> t), XSJ -03f0 (�-011. 1 JL <br /> P:-a i:cYG¢ naslAess ownvnlopn�a/m ID >,clwm ✓lew lisf ¢ort 15 AIlderscn.(JcTruck,vty $ Pnc;pj�slayc/oy�sfr'cs , 1y,/3,�1a✓yy <br /> LV+k+MAE.rpr��)I ISB5ntaoyclnaumuxTPPkolcum/c,.ne.rlPefrvleuvn/- IIr1 IJarg(KoslelPoxt+fyFnM5). ProoictadcD4 <br /> 1415"AAdaxAAyr. Nrt�vutell /suratev6..D.le't'tnt (bri�5i�Avy(DO.N-art✓e�:� RDVldecilfiklu tbJIh()ekI'a'J9E.trUd�s�tisbt, ,v4 <br />