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DATE RECEIVED EHD LOG NUMBER <br /> ��� 14th SAN JOAQUIN COUNTY <br /> :nlly c�- Iv: NVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> J t6� Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd ' <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Terry Nephew tnephew@kleinfelder.com BUSINESS/AGENCY: Kleinfelder <br /> ADDRESS: 5125 N. Gates Ave., Ste 102 CITY/STATE/ZIP: Fresno, CA 93722 <br /> PHONE (1): 559-577-1459 PHONE (2):559-647-3842 FACSIMILE:559-442-5081 <br /> TENTATIVE*APPOINTMENT DATE: 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 - ��,�1 _ J�. +f_�ivf?, ��C, �� DATE <br /> Electronic Information: ❑ List❑ Map--Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑ Unit 1 <br /> 1. 400 East Main St. Stockton C_)✓ <br /> 2. 47 South San Joaquin St. Stockton ❑ Unit 2 <br /> 3. 236 East Miner Ave. Stockton <br /> 4. 700 East Market St. Stockton <br /> Q Unit 3 l <br /> 5. 400 South Aurora Stockton <br /> 6. 521 East Main Stockton <br /> ❑-Unit 4 <br /> 7. 632 South EI Dorado Street Stockton <br /> 8. 423 North Madison Stockton ❑ Unit 5 <br /> 9. 402 West Weber Ave Stockton <br /> 10. 40 Lincoln Street ❑ Unit 6 <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 /> ® <br /> HAZARDOUS WASTEMAZARDOUS MATERIALS ❑MOTEL/HOTEL ❑PUMPER TRUCKIYARDICHEMICALTOILETS <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 <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-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. 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 /> EHD 48-06 <br /> i Ali 4li'l <br />