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DATE RECEIVEDk EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL 14EALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> 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 /> TENTAT/VE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQU.ST-$126 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANTf� ( � j't'/ ?„// ; /- lc%jact1 DATE <br /> Electronic Information: ❑ List ❑ Map-- Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City <br /> 1. 400 East Main St. Stockton �� t "- <br /> 2. 47 South San Joaquin St. Stockton tvv/1/1 o ❑ Unit2 <br /> 3. 236 East Miner Ave. Stockton AUv Gt�l Gl <br /> 4. 700 East Market St. Stockton UAM M I W D'Unit 3 fp <br /> 5. 400 South Aurora Stockton u�T-(�2) I I*�E ` <br /> 6. 521 East Main Stockton j, CIO { c.O aUnit 4 j <br /> 632 South EI Dorado Street Stockton <br /> ru r <br /> w <br /> r.8. 423 North Madison Stockton k o tQ ❑ Unit 5 <br /> 402 West Weber Ave Stockton � jov N D up/w <br /> . 40 Lincoln Street f i 0 GOO ❑ 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 -13 <br /> ®OTHER CLEANUP SITE(NON-LOP) [IHOUSING ABATEMENT ❑WASTE TIRE­j,&4Ij JP 5 (Vol Ud"1 ( <br /> ®UNDERGROUND TANK(MONITORINGIREMOVAL)�1_ ❑FOOD FACILITY ❑DAIRY 1y (,e, 10- <br /> ®ABOVEGROUND TANK 4_ ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> ®HAZARDOUS WASTEIHAZARDOUS MATERIALSj- ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOO/BODY PIERCING ❑COMPLAINT/RESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC Pi 700 /WU--r j— 60Dt)Oq Fj n t1'W f j e , (CLUDING HOLIDAYS) <br /> 1. List up to ten addr QW Ma;n— W LrD 310713(Prc)pb 5,5,f I-Pt, _7/Z.y/0q C' /z) li-L,a"1&)Z4�'Lll t( f the appropriate <br /> box(es). At least c CN 4-1-,C7 or 5, (e cerpt- {from ctee"7 up) , n U`2-T r✓i,� :d above. Address <br /> ranges will not be y� �}�Ir'Orq_ CO 00 3S3o'1((P 151 )d ca DD 35 a U5C�P1—S 1D6 ons received after <br /> 3:00 pm will be pry Io�lb f�q DI��D n CDIs4^led Hew Ale- <br /> 2. The EHD will notif �Zy �frj ��1 5i�1�d C��£3;Uqz r�5W) �� approximately ten(10) <br /> days after receipt fj3� C I D�r-dc4O- C f73'�S7��AP�D s�t rry) i• Appointments <br /> should be schedu +W 1�-W i-l(f I'D,- P��s li 1V115. (4� ty-a <br /> h n <br /> 3. A file that is active ,�- W 0036 bV-7 ((Qf S 10 a 3/A)/ 7 01 P-� ..w application may be <br /> submitted when tl (0 P,,CC) <br /> cr�C,150 n - L6CA"3 D��C(Cr + ,10, n ��n�,• Cd�1a Je c.�lQ vtyle <br /> 4. Any file not returr t��v /u to Cse of the applicant. <br /> Future file review! icant may require a$125 deposit prior to review_ ***BOXED AREA-EHD USE ONLY*** <br /> DO Gti n r� 0- !�• �T) <br /> Zo EI y-7 iui�sxtau;n <br /> .� f� «, <br /> 1�.� � Ie 'ti I ku-I��e ie, 9-- Ply 'o <br /> $ o s�o 90 <br /> W <br /> can du•na 12/19/12 <br />