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0/26/2010 11:56 5308727468 PAGE 01/02 <br /> U k <br /> � EHQ LOG NUMBER <br /> �4 ISD SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> LI(', 2. 6 010 600 East Main St. Stockton, CA 95202-3029 <br /> HEA"phone: (209)466-3420 Fax: (209)464-0138 Web:vvww.sjgov.org/ehd <br /> FERIN",iTiSERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Pinnacle Environmental, Inc. BUSINESS/AGENCY: <br /> ADDRESS: PO Box 1956 CITY/STATE/ZIP: Paradise, CA 95967 <br /> PHONE(1): 530/872-2958 PHONE(2): FACSIMILE: 530/872-2968 <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-"Tentative only-must be confirmed) <br /> ❑ CHECK SOX TO EXPEDITE REQUEST-$11155 FEE CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT C' -!% �/ �� DATE /l4 <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City it 1 <br /> 1. 2180 E. Mariposa Ave., Stockton 'hGj �Z I <br /> 2. ❑Unit 2 <br /> 3. <br /> 4. Unit 3 3 <br /> 5. <br /> 6. nit 4 <br /> 8. ED Unit 5 <br /> 9. <br /> 10. Unit 6 <br /> specific Date Range of Information Requested: From to lQ�� <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES n / <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSNG ABATEMENT ❑ SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE k <br /> i <br /> UNOFROROUNO TANK(MONITORINGIREMOVAL)�K, ❑DOG KENNEL Ll DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT t(]'71 ` <br /> TIERED PERMITTED FACILITY D MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> TATTOO/BODY PIERCING ❑POOL/SPA ❑LAND 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;00PM(EXCLUDING HOLIDAYS) <br /> 1- Lls up to ten addresses in the space above. Select the type(&)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected, Fax tc (209)4640138 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 tan(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$115 deposit prior to review. <br /> 5. If you need further assistance,please contact Diane Martinez,at(209)468-3425. <br /> EHD USE ONLY <br /> O -I <br /> END 40.06 0127/08 <br />