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IPA D VED EHD LOG NUMBER SAN JOAQUIN COUNTY EN ONMENTAL HEALTH DEPART �: 4T OCT 2 9 201 Qi600 East Main St. Stockton, CA 95202-3029 elephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/e l5v ENVIRONMENTAL HEALTH PUBLIC RECORDS RELEASE APPLICATION PEBA4ff4c ;E-ra APPLICANT: ED MACDANIEL ADDRESS: 3210 GOUGH STREET #105 PHONE (1): 415-240-3205 PHONE (2): TENTATIVE* APPOINTMENT DATE. (Please allow 10 business days from date of application ❑ CHECK BOX TO EXPEDITE REQUEST - $1 SIGNATURE OF APPLICANT Electronic Information: ❑ List ❑ Map ..- Description: BUSINESS/AGENCY: PARTNER ENGINEERING CITY/STATE/ZIP: SAN FRANCISCO, CA 94123 FACSIMILE: 415-707-2038 _ Time: y - must be confirmed) Y) - REQUEST PROCESSED IN 3 BUSINESS DAYS DATE 10/27/2010 FILE ADDRESS I EHD usF nmi v Specific Date Range of Information Requested: From to ENVIRONMENTAL HEALTH DEPARTMENT FILES ® UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT ® SOLID WASTE FACILITYIVEHICLE 5 ® OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY ® UNDERGROUND TANK (MONITORING/REMOVAL)Ok ❑ DOG KENNEL ®WASTE TIRE yn ❑DAIRY ® HAZARDOUS WASTE GENERATOR ElCHICKEN RANCH )I z�,� ® TIERED PERMITTED FACILOTY,,,,( ®WASTEWATER TREATMENT PLANT v°\ ❑ MOTEL/HOTEL ❑ PUMPER TRUCKIYARD/CHEMICAL TOILETS F]TATTOOIBODY PIERCING F1 POOL/SPA ❑ LAND USE APPLICATION SITES ❑ MEDICAL WASTE FACILITY ® OTHER (PLEASE SPECIFY) WELLS (WATER & MONITORING) & SEPTIC WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:00PM (EXCLUDING HOLIDAYS) 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 one file type MUST be selected. Fax to (209) 464-0138 or mail to the address indicated above Address ranges will not be accepted - for additional assistance with file addresses, contact the EHD. Applications received after 3:00 pm will be processed the next business day. 2. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten (10) days after receipt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may be submitted when the file is available. 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 reviews by the same applicant may require a $122 deposit prior to review. Street # Street Name City 1. 8035 AND MARINERS DR. ❑ Uit 1 STOCKTON ��I ; �UD (��l i 3oto) 2. - —� 3555 WEST HAMMER LANE STOCKTON it 2 O/ 5 3. 4..., 5. 6. — - — nit 4 7. 8. — it 5 9 :;nit 10. 6 Specific Date Range of Information Requested: From to ENVIRONMENTAL HEALTH DEPARTMENT FILES ® UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT ® SOLID WASTE FACILITYIVEHICLE 5 ® OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY ® UNDERGROUND TANK (MONITORING/REMOVAL)Ok ❑ DOG KENNEL ®WASTE TIRE yn ❑DAIRY ® HAZARDOUS WASTE GENERATOR ElCHICKEN RANCH )I z�,� ® TIERED PERMITTED FACILOTY,,,,( ®WASTEWATER TREATMENT PLANT v°\ ❑ MOTEL/HOTEL ❑ PUMPER TRUCKIYARD/CHEMICAL TOILETS F]TATTOOIBODY PIERCING F1 POOL/SPA ❑ LAND USE APPLICATION SITES ❑ MEDICAL WASTE FACILITY ® OTHER (PLEASE SPECIFY) WELLS (WATER & MONITORING) & SEPTIC WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:00PM (EXCLUDING HOLIDAYS) 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 one file type MUST be selected. Fax to (209) 464-0138 or mail to the address indicated above Address ranges will not be accepted - for additional assistance with file addresses, contact the EHD. Applications received after 3:00 pm will be processed the next business day. 2. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten (10) days after receipt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may be submitted when the file is available. 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 reviews by the same applicant may require a $122 deposit prior to review.