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DATE RECEIVED _ /T !! N BER <br />SAN .1OAQUIN COUNTY C(D D <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />�j J'� 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Tele l one: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: ABBY PEPPER <br />ADDRESS: 10559 CITATION DRIVE, SUITE 100 <br />BUSINESS/AGENCY: ARCADIS <br />CITY/STATE/ZIP: BRIGHTON, MI 48116 <br />PHONE (1): (810) 225-1944 PHONE (2): (810) 229-8594 FACSIMILE: (810) 229-8837 <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 1 FOR APPLICANT DATE 718114 <br />r <br />Electronic Information: ❑ List ❑ Map — Description: <br />FILE ADDRESS <br />EHD USE ONLY <br />❑Unit 1 <br />Street # <br />Street Name City <br />1.. <br />2979 <br />AUTO CENTER A STOCIFTON <br />W Ht\ Nou��P <br />Unit 2 <br />2. <br />, - <br />3. <br />Unit 3 <br />4, <br />5. <br />Unit 4 <br />6. <br />V <br />7. <br />�, 2 <br />❑ Unit 5 <br />8. <br />9. <br />.1nit 6 <br />10. <br />Specific Date Range of Information Requested: From to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES ,! <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ MEDICAL WASTE FACILITY []SOLID WASTE FACILITYIVEHICLE a 1'L1�o <br />[VIOTHER CLEANUP SITE (NON -LOP) F1 HOUSING ABATEMENT ❑ WASTE TIRE LA I <br />`UNDERGROUND TANK (MONITORINGIREMOVAL) ❑ FOOD FACILITY ❑ DAIRY <br />BOVEGROUND TANK F1CHICKEN RANCH/ DOG KENNEL [:]WASTEWATER TREATMENT PLANT <br />_HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑ MOTELIHOTEL ❑ PUMPER TRUCK/YARDICHEMICALTOILETS <br />TIERED PERMITTED FACILITY ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br />❑ TATTOOIBODY PIERCINGCOMPLAINTIRESPONSE RECORDS ❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:OOPM (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 $125 deposit prior to review. 'BOXED AREA- EHD USE ONLY*** <br />❑Records provided by Staff -PPR Complete. staff Name: <br />4128114 <br />EHD 48-06 <br />