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03/16/2010 10:46 5308722968 PAGE 01/01 <br /> U U E af <br /> f1#1 E[0 EHD <br /> LOG NUMBER <br /> U l] SAN JOAQUIN COUNTY <br /> j <br /> 2 0 10 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202-3029 <br /> ENVIRUNIVIENT HEALTH Telephone: (209)468-3420 Fax: (209) 464-0138 Web: www.sjgov.or /e <br /> 1 ZGZ <br /> PERM117SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> ) cz Co t�pz:- (.o -Pre <br /> APPLICANT: Pinnacle Environmental, Inc. BUSINESS/AGENCY: <br /> ADDRESS: PO Box 1956 CITY/STATE/ZIP: Paradise, CA 95967 <br /> PHONE(1): 5301872.2958 PHONE(2): FACSIMILE: 530/872-2968 <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date Of dppliCAtlon submittal-"Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$115 FEE(CA$H OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> FE <br /> Electronic Information: ❑List[] Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Strout# Street Name City _ 13 Unit 1 <br /> 1. 248 Industrial Dr., Stockton H ,OEy O/ <br /> — Unit 2 <br /> 3. Tl <br /> 4. W <br /> nit <br /> 6. <br /> !it 4 <br /> 7. I' <br /> - -_ <br /> 9. _ ❑Unit 5 <br /> 10. <br /> Unit 6 <br /> Speclfio Date Range of Information Requested: From to (� <br /> ENVIRONMENTAL.HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITYNEHICLE ` <br /> THEA CLEANUP SITE(NON-LOP) 0 FOOD FACILITY [:1 WASTE TIRE (� <br /> UNDERGROUND TANK(MONITORINGIREMOVAL)A ❑DOG KENNEL ❑DAIRY C l/ <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> IERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS t <br /> r <br /> ATTOOIBODY PIERCING POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITYOTHER(PLEASE SPECIFY) S/7/%ISllea(�QSES <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS <br /> 1. Last up to teen addresses in the space above. Select the type(s)of flies from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. ax to 209 464-0138 or mail to the address In4j1paIWO 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 he 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 rile reviews by the Same applicant may require a$115 deposit prior to review. <br /> 5. If you need further assistance,please contact Diane Martinez,at(209)4883426. <br /> EHD USE ONLY <br /> i <br /> �3 - ) <br /> EHO A8-08 <br /> 8!27/09 <br />