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W01/2-0-1��Tff[V <br /> 14159529421 )12094640138 01 <br /> EHD LOG NUMBER <br /> • SAN JOAQUIN COUNTY • <br /> MAY 0 t 2097 ENVIRONMENTAL HEALTH DEPARTMENT V6070 <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> tW-VRON�.ALI. fglephone: (209) 468-3420 Fax: (209) 464-0138 Web: www,sjgov.org/ehd <br /> PEr,WITfSERv,l!!M5 . <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> COPY- <br /> APPLICANT: David Gerhardstein BUSINESS/AGENCY: Partner ESI <br /> ADDRESS: 111 Pine St, STE 1 750 CITY/STATEIZIP: San Francisco, CA 94111 <br /> PHONE(1): 415 -599 . 1184 PHONE (2): FAX OR E-MAIL: _ __ <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 /> '_Cf EO .T0: PEt)iTE,RE. VEST` $130 FEE(QASii:(iR`Ciil CK-QNLY1 :f�.EQUEST.PRO.GESSE3;(NSi3US3NESS0AYS � (1 <br /> SIGNATURE OF APPLICANT dgerhardstein@partneresi .corn DATE May 2017 `�� <br /> Electronic Information: ❑ List ❑ Map-Description: <br /> FILE ADDRESS <br /> EHD USE ONLY <br /> Street _ Street Name --- - -I City <br /> Ll <br /> " :17720 Murp-hy Parkway Lati:rop <br /> 1 <br /> 2. -1-7-122 Murphy Flarkw:ay Lathrop jP1i9 V�� <br /> 3. <br /> 4. <br /> D <br /> 5. <br /> 6. 4(-4 <br /> . <br /> ti� <br /> 7. ' <br /> 1. <br /> 8. <br /> P'P SITE MITIGATION <br /> 9• <br /> 10. <br /> Specific Date Range of Information Requested; From to <br /> EIV:VIRC)NMEt!13AI_HEALTH:DEATM [�IT:FILES <br /> Q UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MOTEL/HOTEL ❑SOLID WASTE FACILITY/VEHICLE <br /> ©OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑FOOD FACILITY <br /> Q UNDERGROUND TANK(MONITORING/REMOVAL) ®WASTE TIRE ❑DAIRY,POOL/SPA <br /> ®ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ©WASTEWATER TREATMENT PLANT <br /> Fxj HAZARDOUS WASTE ❑MEDICAL WASTE FACILITY ❑PUMPER TRUCK/YARD/CHEMICAL TOILETS <br /> Fxj HAZARDOUS MATERIALS ❑TATTOO/BODY PIERCING ❑LAND USE APPLICATION SITES <br /> Q TIERED PERMITTED FACILITY Q COMPLAINT/RESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 8M-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(200)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$130 deposit prior to review. <br /> ***BOXED AREA-EHD USE ONLY`** <br /> fv - <br /> r7 �ewnrdn .�r...ri.lo.� bar C•�f4_flDD c0.....;le•o Staff Name: <br /> Received me= <br /> TiMa,y. 1, -2017_12 . 07PGNo. 1360 <br />