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01/11/2016 12:57 PM 14159529421 ->12094640138 0 2 <br /> VED SA.N JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT 647" <br /> .SAN 11 2016 1868 East Hazelton Avenue, Stockton, CA 95205-6232 92. <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehri <br /> MRONMENTAL HEALTH <br /> PMmwSERViC_E.q PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Brian Kim BUSINESSiAGENCY: Partner Engineering& Science, Inc. <br /> ADDRESS: 111 Pine Street, Suite 1750 CITYiSTATEi , P: San Francisco, CA 94111 <br /> PHONE(1): (415) 680-8953 PHONE (2): FAX OR E-MAIL: (415) 952-9421 <br /> fpl aS� allee�+1f1 himirtage Thole /=turf date ref nnnIi_:%Hnri cpihmfFfwl€or ffin rnCOr: S t <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> ❑ CHECK SOX TO EXPEDITE REQUEST-$130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ' BATE January 11, 2016 <br /> Electronic Information: ❑ List ❑ Map–Description: <br /> FILE ADDRESS <br /> cc `♦1� E O USE ONLY <br /> $treat 4 Stre-e,Name C1-,y <br /> 1 520 West Lodi Avenue Lodi 1 i NO t J <br /> fel L)nlf 1 <br /> Cb <br /> ED-unn 2 <br /> 5. <br /> 624,It 3 <br /> 5. <br /> Q'Untt 33HM <br /> 7• atglt 4 <br /> 8. <br /> 10 i 'Unit 5 <br /> Speclflc Date Range of Infonnatfon Requested: From All to All <br /> ENVIRONMENTAL' HE—Al TH DEGA G-�.7E:T=15 ES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) Q MOTELiHOTEL SOLID WASTE FACfLrryrIEHICLE !, � �L f <br /> MOTHER CLEANUP SITE(NON-LOP) Q HOUSING ABATEMENT ®FOOD FACILITY 1 CD k"'('�A4 , <br /> Q UNDERGROUND TANK(MoNiToRINGfKEMOVAL)o`, Q WASTE TIRE Q L)AIRY,POOLISPA <br /> ❑X ABOVEGROUND TANK-- Q CHICKEN RANCH/DOG KENNEL Q WASTEWATER TREATMENT PLANT <br /> n HAZARDOUS WASTE v ❑X MEDICAL WASTE FACILITY Q PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> Q HAZARDOUS MATERIALS Q TATToofBODY PIERCINGX❑LAND USE APPLICATION SiTES <br /> 0 TIERED PERMITTED FACILrTYa- ❑X COMPLAINTiRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 Am-5:00PFt(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 mall 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 c{w identi."J .n the "t" and content of EHO records, p!casa contOact.EHD at the riurTlucr noteu above. <br /> 3. The EHD will notify the applicant if any EHD flies exist. An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The flies 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 /> r-I 0n^^.A� mr—i A—A b.• C6nfa_nQ0 P`Ora —[^*n Staff Name: <br /> Received Time_Jan, 11, e2016_12;57PNENo. 0320 <br />