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DATE <br /> 4D EHD LOG NUMBER <br /> � 0 If SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT " <br /> FES 2 3 2016 1868 East Hazelton Avenue, Stockton, CA 95205-6232 t� <br /> Telo lone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org ^3 M T <br /> >; iia l I ITi .J31 1, 9' PUBLIC RECORDS RELEASE APPLICATION r1E L F <br /> APPLICANT: Kristine Savona BUSINESSIAGENCY: Hillmann Consulting, LLC <br /> ADDRESS: 1745 W. Orangewood Ave, Ste 110 CITY/STATE/ZIP: Orange, CA 92898 <br /> FACSIMILE ksavona(Dhillrnanngr <br /> Phone (1) 714-834-9500 PHONE (2): / E-mail: oup.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 BOX TO EXPEDITE REQUEST-$130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT See Attached DATE <br /> Electronic Information: ❑ List ❑ Map—Description: <br /> FILE ADDRESS <br /> Street # Street Name city EHD USE ONLY <br /> 1. 1310 Dupont Manteca <br /> ❑ Unit 1 <br /> 2. 1312 Dupont Manteca <br /> 3. 1314 Dupont Manteca gr Unit 2 <br /> 4. 1318 Dupont Manteca <br /> ❑ Unit 2H n r <br /> 5. 1320 Dupont Manteca <br /> Unit 3 <br /> 6. 1322 Dupont Manteca Unit 3HM <br /> 7. 1324 Dupont Manteca <br /> �' El Unit 4 <br /> $ 1-0 1 12 ! 11 : SITE MITIGATION <br /> 9. <br /> 10. �. Unit 5 <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 /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ®WASTE TIRE <br /> ®UNDERGROUND TANK(MONITORINGIREMOVAL) ❑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 /> ❑TATTOO/BODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00pm(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 box(es). At least <br /> one file type MUST be selected. Fax to(209)464-0138 or mail to the address indicated above. Address ranges will not be accepted. <br /> 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)days after <br /> receipt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled <br /> 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. Future file <br /> reviews by the same applicant may require a$130 deposit prior to review. <br /> ***BOXED AREA-EHD USE ONLY*** <br />