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PAGE 01/02 <br /> 10/26/2010 11:56 5308728 <br /> (�� EHp LOG NUM9ER <br /> ��f111j E10 SANJOAQUINCOUNTY 1` <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> I,IC 12. 6 4010 600 East Main St. Stockton, CA 95202-3029 <br /> ENVIRONN,"I�Nff HEAEMphone: (209) 468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> PERVMIT,SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Pinnacle Environmental Inc. BUSINESSIAGENCY: <br /> ADDRESS: PO Box 1956 CITYISTATE/2.IP: Paradise, CA 95967 <br /> PHONE (1): 630/872-2968 PHONE(2): FACSIMILE: <br /> 63018172-2968 <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from data of application submittal-"Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUE�E-(CA H OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS p <br /> SIGNATURE OF APPLICANT / DATE /D --Ze'– 20/ <br /> Electronlclnformation: ❑ List❑ Map–Description: <br /> FILE ADDRESS EHD USE ONLY <br /> N / street 0 street NameGity it 1 <br /> �1v 1. 2180 E. Mariposa Ave., Stockton 07 I — I <br /> Unit2 <br /> T <br /> 2. ��..,.T_ Qx <br /> 3, /� <br /> 4S. unn 3 <br /> nit 4 <br /> S. <br /> 8 C3 units <br /> 9. <br /> 10. Cl Unit 6 <br /> Specific note Range of information Requested: From to <br /> I n <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES nnL <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING A13ATEMENr ❑ SOLIDWASTE FACILITYNEHICLE 'X <br /> OTHER CLEANuPSnE(NON-LOP) ❑Fool)FACILITY El WASTE TIRE I Ip'lil <br /> UNDERGROUND TANK(MONITORINGIREMOvAL)DK ❑DOG KENNEL ❑DAIRY 1N� �/�„r� <br /> HAZARDOUS WASTE GENERATOR if ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT JO'v <br /> �TIERED PERMITTED FACIUTP� ❑MOTELIHOTEL ❑PUMP ERTRUCKICARON ITESALTOILEfS <br /> TATTOOISODY PIERCING ElPooLISPA ❑LAND U6EAPPLIATISITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL ANP SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5;00PM(EXCLUDING HOLIDAYS) <br /> 1. Lts uo to tenaddresses in the space above. Select the types)of files from the list above by checking the appropriate <br /> box(es). At least one fila type MUST be selected, Fax to(209)464.0138 or mail to the address indicated above. Address <br /> ranges will not be accepted.for additional ZSSlstance with file addresses,contact the EHD. Appllcatldns received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten(1 D) <br /> days after receipt of application. The files will be hold for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immadiataly available for review. A new application may be <br /> submitted when the Ole Is available. <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 Ole reviews by the same applicant may require a$115 deposit prior to review. <br /> S. If you need further assistance,please contact Diane Martinez,at(209)468-3425. <br /> EHD U E ONLY <br /> ( <br /> al2V09 <br /> ENO ARM <br />