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SANJOAQUIN RECEIVFFAironmental Health Department <br /> COUNTY MAY 15 2018 PUBLJC RECORDS RELEASE APPLICATION <br /> • ENVIRONM N7NNIW@a 5Ab <br /> PEHD LOG NUMBER: <br /> FRraI <br /> APPLICANT: Awam Dommgoaz BUSINESS/AGENCY:Penner Engineexy ono sr er,ra <br /> ADDRESS: IOTnma Al,p,e Sun.10 CITYISTATEIZIP:Seduced eaiuwnia MGM <br /> PHONE(1): 650-99,2876 PHONE(2): FAX OR E-MAIL: xhuuc dammgxez@Ime.c,x, <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 /> SIGNATURE OF APPLICANT Alvaro Ddmmguee DATE I.,, <br /> 1. List up to ten addresses in the space below. Address ranges WILL NOT be accepted. Select the types)of files from the <br /> list below by checking the appropriate box(es). At least one file type MUST be selected. Fax to 1209)46 .0138,mall to the <br /> address indicated below,or email to info®sicethd.com. Applications received after 3:00 pm will be processed the next <br /> business day. <br /> 2. For assistance In identifying the nature and content of EHD records, please contact EHD at the number noted below. <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$152 deposit prior to review. �4 <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 to fL, <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENTI.� <br /> FILES (Specific addresses only,address ranges will not be aecepted) EHD U E QN <br /> nX Underground Taak(UST) street# Street NameCity {� <br /> 40 <br /> cleanup Site(LOP) ♦ ❑c,xsuusn <br /> ❑x ONe,clurcupaYe04m 0P ' 1250 South Wilson Way At -1b tockton leo- <br /> • QHazardouswe. us-r 011;L.31a4 _W <br /> F1 Tleted Pruett Ful a 1250 South Wilson Way Stockton yI- / CD <br /> Q AWwgmund Tank s <br /> ❑X UST (MonitoAllg/RemMd1) D WVS <br /> ❑x Hazardous Makiials . t <br /> HM Hw UST <br /> nX Split/Release Response rsneunmr <br /> Q Sets week,FuSu /Vep dkr e <br /> ❑FWd Fedlity <br /> ❑pod I Me IRV,ilrevuex <br /> ❑Deily s <br /> ❑Land Use APPliGtlon Slks <br /> DHe- <br /> 7 Sephe <br /> o7Sepxc Pumper Truck a <br /> Yazd/Chemical Texts <br /> ❑weve—kir Treetmenl Pknl GUPA <br /> ❑Housing Abakmant r MTI HM IHW <br /> ❑MmellHaal <br /> ❑Chicken Randl 10,Kennel W15UPA <br /> ❑Medical water Facht, a WT <br /> TetlmYWy Plerd,q Scu,ww+rz <br /> ❑wrists TVe B <br /> E]Complain, <br /> ❑Other(Please Speclryk D ACtouxiwa <br /> rd <br /> —BOXED AREA-EHD USE ONLY'^ <br /> r 0 5 <br /> ti kf <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-34,301 F 2p9 964-0138 s ce d <br /> 5 Z3 18 {�Du:dPd GI7r�1: �P��PSry? <br />