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00"EIVE® <br /> E ECEIVED �j'��� SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> MAY 15 2097 ' y.tGj ENVIRONMENTAL HEALTH DEPARTMENT fle 14 <br /> � ' <br /> enue,Stocon, CA 9 <br /> ENVIRONMENTAL HEALTH Telephone$(09)468-3420 Fax68 East Hazelton : (209)464-0138 Web5205-6232 www.s gov.orglehd <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Jordan Amarant BUSINESS/AGENCY:PMZ Real Estate <br /> ADDRESS: 1120 Scenic Dr CITY/STATEIZIP:Modesto, CA 95350 <br /> PHONE(1): 209-345-8209 PHONE(2): FAX OR E-MAIL: jamarant§pmZ.com <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> ®CHECK 60X TO EXPEDITE REQUEST,-_$.739 FEE(O SH OR CHECK LX} QUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT —'-"'/ DATE <br /> 1. List uD 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 (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 appoment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The files will be held for a max iintmurn 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. S/� <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: Front ALL to <br /> ENVIRONMENTAL -Ltd <br /> HEALTH DEPARTMENT FILE ADDRESS FILES EHD U E OIV LY <br /> UNDERGROUND TANK(UST) Street# Street Name city <br /> CLEWUP SRE(LOP) 'n U`1('P� CONSUYEx <br /> OIHER CLEmup SDE(NDN-LOP t (pJ / , ao <br /> 411 EYosemiteAve Manteca <br /> 2 HAWi us WASTE <br /> ONR <br /> @TIERFD PEWAITTED FAGLTTY p <br /> m ABOVEGROUND TANK <br /> UST (MONffMW I REMOVAL) 0 pm <br /> 10 HAEARDOUS MATERMLS S <br /> [;j SPILURELEASE RESPONSE <br /> (a SOLID WASTE FA UWI VEHICLE ATEA Wurtr <br /> 4 <br /> m FGOD FACIUIY <br /> m POOL/SPA - $DE MmwTax <br /> DXW b <br /> ®LAND USE APPLK:AT SRES <br /> ®SEPTIC PUMPERTHUGK I HWSIx4 <br /> e <br /> YAADI CHEMIOAI TOILETS <br /> WfSTEWATm TPEATAIEw PIAN! <br /> COPA <br /> WHWSINGAHATERIEM r <br /> ❑MOTELRHOTEL <br /> ❑CHICKEN RANCH I Doo KENNEL CUPA-UBT <br /> m MEMM WASTE FACKRY S <br /> TATTOOMMY PIEMING <br /> ®WASTETIRE S ID WASTE <br /> 9 <br /> m COMPWNT <br /> OTHER(PLEASE SPECIFY): ElACC ,.. <br /> TO <br /> —BOXED AREA-EHD OSEONLY"` <br /> cp <br /> 11 <br /> ❑ Records provided by Staff-PPR Complete. staff Name: <br /> EHD 48.08 <br />