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From:fax Fax:(209)740-4303 To: Fax: +1 (209)4640138 Page 2 of 2 07/15/2016 12:45 PM <br /> D � "t� SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> JUL 15 2011 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Tele hone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd 76T <br /> RONMENTAL HEAL. <br /> HERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: HeatherGemmng BUSINESS/AGENCY: enviroAssessment PC <br /> ADDRESS: PO box 1154 CITYISTATE/ZIP: Banners Ferry,ID 63805 <br /> PHONE(1): 844-742-7311 PHONE (2): FACSIMILE: 877-623-5493 <br /> TENTATIVE*APPOINTMENT DATE: N/A(autofstete,need mailed oremaiied) Time: <br /> (Please allow 10 business days from date of application submittal -*Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT Heather Gemmrig ---- ------ DATE July 15,zots <br /> Electronic Information: ❑ List ❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street#P Street Name City <br /> Unit 1 <br /> 1. <br /> Miner Avenue (APN 15312003) Stockton <br /> 2. ('1 1 •vrl�'1U( cJ'1� - E�Unit2 <br /> 3. <br /> 4. E?I Unit 3 <br /> 5. <br /> 6. d unit 4U�( <br /> 11"k 6 <br /> 9. <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 <br /> 0 OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> Q UNDERGROUND TANK(MONRORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ©ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> ❑® HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING i❑COMPLAINTIRESPONSE 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 flies from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0136 or mail to the address Indicated above. Address <br /> ranges will not be accepted -for additional assistance with file addresses, contact the EHD. Applications 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 (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 /> 3. A file that Is actively being worked on by EHD staff may not be Immediately available for review. A new application may be <br /> submitted when the file is available. <br /> 4. Anyfile 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 /> IdP 13`/Staff-PPR CoMplete. staff Name _ <br /> Received Time Jul, 11), 2016 12 :45PM No, 0978 "� <br />