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• <br /> ft <br /> RECEIVED SAN JOAOUIN COUN Copy EHD LOG NUMBER <br /> M/YR 26 20I2 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Sau San — _ BUSINESS/AGENCY: Partner Engineering & Science <br /> ADDRESS. 400 2nd Street, Suite 415 CITY/STATE/ZIP:San Francisco, CA 94107 <br /> PHONE (1): 415-373-6317 _- PHONE(2): _ _ FACSIMILE:415-889-6020 <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 EXPEDITER 12.2 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 3/26/12 <br /> Electronic Information: ❑ List ap-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street ff Street Name _ City ❑Unit 1 <br /> 1. 2650 North MacArthur Blvd Tracy <br /> 2. Unit 2 <br /> 3. <br /> -- — - -- Unit 3 <br /> 5. <br /> 6. <br /> - - -- /Z/Unit 4 <br /> 7. <br /> 8. - -- <br /> ❑ Unit 5 <br /> 9. <br /> 10. <br /> Unit <br /> Specific Date Range of Information Requested: From All to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) El HOUSING ABATEMENT SOLID WASTE FACILITYIUEHICLE,*SW <br /> OTHER CLEANUP SITE(NON-LOP) El FOOD FACILITY WASTE TIRE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) ❑DOG KENNEL DAIRY <br /> HAZARDOUS WASTE GENERATOR CHICKEN RANCH WASTEWATER TREATMENT PLANT <br /> IERED PERMITTED FACILITY ❑MOTELMOTEL PUMPER TRUCK/YARD/CHEMICAL TOILETS <br /> TATTOO/BODY PIERCING ❑POOLISPA VdLAND USE APPLICATION SITES <br /> .MEDICAL WASTE FACILITY ❑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 ub 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$122 deposit prior to review. <br /> EHD USE ONLY <br /> EHD48-06 _-- ---- ----- 07/29/10 <br />