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DECEIVED 10 <br />SAN-JOAQUIN MA 16 2018 Environmental Health Department <br />COUNTY PUBLIC RECORDS RELEASE L V APPLICATION <br />EIV1/IRQNIi� (W'2(W'214.PEAMR <br />EHD LOG NUMBER: <br />APPLICANT: Darnel i Navone BUSINESS/AGENCY: Pacific Car Wash & Mark,etplac:e. Inc <br />ADDRESS: 4405 Pacific Avenue CITY/STATE/ZIP: Stockton. CA 9520 <br />PHONE (1): 209.482-5540 PHONE (2): 209 -60s -9s00 FAX OR E-MAIL: prwash0comcasTnea <br />Please allow 10 business days from date of application submittal for the records to be available. <br />Staff will contf" rrange an appointment date and time to review the requested records. <br />SIGNATURE OF APPLICANT %I--,Rt1 �. — _, DATE 3 15 2ctb <br />1. List up to ten addresses in the space delow. Address ranges WILL NOT be accepted. Select the type(s) of files from the <br />list below by checking the appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-0138, mail to the <br />address indicated below, or email to info(ipsicehd.com. Applications received after 3:00 pm will be processed the next <br />business day. <br />2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted below. <br />3. 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 />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 $152 deposit prior to review. <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) <br />Electronic information: ❑ List ❑ Map — Description: <br />Specific Date Range of Information Requested: From to <br />ENVIRONMENTAL <br />o e,' p,pie <br />Ins Plari Ofocjap.4pmqueuWS <br />FILE ADDRESS <br />—_pawcr.rh <br />- , n ��.2,� -- <br />HEALTH DEPARTMENT <br />FILES <br />Staff -PPR Complete. staff Name: <br />(Specific addresses <br />9 <br />only,address ranges will not <br />he accepted) <br />p <br />EHD USE ONLY <br />Underground Tank (UST) <br />Street * <br />Street Name <br />City <br />( 1 <br />-r cS <br />C�"G Ave. <br />❑CONSUMER <br />Cleanup Site (LOP) <br />Other Cleanup Site (Non -LOP( <br />! <br />J ! t/v�� <br />F7 Hazardous Waste <br />p DAIRY <br />F7 Tiered Permitted Facility <br />2 <br />Aboveground Tank <br />PWS <br />UST (Monitoring / Removal) <br />Hazardous Materials <br />3 <br />�. <br />r `4 <br />E] Spill / Release Response <br />Solid Waste Facility / Vehicle <br />�', , , LEAD <br />WATER QUALITY <br />4 <br />Food Facility <br />❑ SITE MrrIc,ATiUN <br />Pool / Spa <br />I] Dairy <br />S <br />Land Use Application Sites <br />HOUSING <br />17 Septic Purnper Truck f <br />s <br />Ya!d i Chemical Toilets <br />❑ Wastewater Treatment Plant <br />CUPA <br />❑ Housing Abatement <br />7 <br />AST IHM lHW <br />F] Motel/Hotel <br />CUPA <br />Chicken Ranch / Dog Kennel <br />Medical Waste Facility <br />8 <br />UST <br />❑ Tattoo/Body Piercing <br />❑ SOI In WASTF <br />❑ Waste Tire <br />8 <br />❑ Complaint <br />Other (Please Specify) <br />ACCOUNTING <br />10 <br />***BOXED AREA - EHD USE ONLY*** <br />Rrp_v_r d td a <br />o e,' p,pie <br />Ins Plari Ofocjap.4pmqueuWS <br />v Lq_ 2rr1_ae _ <br />—_pawcr.rh <br />- , n ��.2,� -- <br />Records provided by <br />Staff -PPR Complete. staff Name: <br />ViannQ Hondo 3 /(b w4 EHD 48.08 <br />1868 E Hazelton Avenue j Stockton, California 952051 T 209 468-34201 F 209 464-0138 1 www.sjcehd.com <br />