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i I SAN JO/ IN COUNTY ENVIRONMENTAL HEALTH Dr 'RTMENT SITE MITIGAe ION MASTER FILE RECORD INFORMm (ION FORM IL6RCo11_ cecaa C^naA FACILITY FILE. COMPI-FTF RI Lclucssa SITcI Don.IenT• lucnoow-nnA.. DAN 7/30/18 SHADED AREAS FOR EHD USE OWNER FILE* COMPLETE PROPERTYOWNER/ RESPONSIBLE PARTY INFORMATION: CNeCrrIFCaWeRISCUe My0NF1L WM EHDE] PROPERTY Buzz Oates PHONE 91B-379 sr -3800OWERNme EiMI Buswass NAME AHST 53 LLC tro estacioLADDRE88 buzzoates.com OWNER HOMEADORESS ATIFMION: osCARe OF (OPTIONAL) Cm STAN LP OWNER MAiLiNOADDRE88 555 Capitol Mall. Suite 900 MAwNOAomeaacm Sacramento STATE ZIP CA 95814 PHON! BUSINESS ❑CORPORATION ❑IWIWOUAL ❑RT PANERSHIP El IV GOVERNMENTAGENCY Ip RESPONSISIEPAM ❑OTHER ® ENVIRONMENTAL ❑ EHD LOCALVOLUNTARY ❑ RWQCIll LEAD- ❑ RWQCB LEAD- zip CLEANUP CORRECTNE ACTION WATER QUALITY(WOR) ❑ DTSC LE=01FEEEPALEM�ASSESSMENT KIWI 2950 2953 29601352613527 2965 2959 FACILITY FILE. COMPI-FTF RI Lclucssa SITcI Don.IenT• lucnoow-nnA.. BUBINE88 NAME MAWNDADDRFS9 DO cm W � ACCOUNTADORE88 TO SEND F7EE9 AND OMAROES: OWNER® sraN C � ATTENNON FACILITY/BUSINESS❑ BILLING AND COMPLIANCF, ACKNOWLP,UChIEN'r: I, the undersigned Applicant, certify that I am the Owner, Operator, Auihoriyed Agent, or Respons/ble Party and I acknowledge that all PERMIT FEES, PENALTIES ENFORCEMENT CHARGES and/or HOURLY CHARGES associated with this project will be billed to me at the address identified above as the ACCOUNT ADDREss for this site. I also certify that all information provided on this application is true and correct; and that all regulated activities will be performed in accordance with an applicable SAN JOAQUIN COUNTY ORDINANCE CODES and/or STANDARDS and STATE and/or FEDERAL Laws and REGULATIONS. As the undersigned Owner, Operator, Authorized Agent, or Responsible Party for the project locate above cil4/1 address, I hereby authorize the release of any and all results, reports, and other environmental assessortin rmntion GJoAQDIN COI NTY ENVIRONMENTAL HEALTH DEPARTMENT as soon as it 9s available and at the same time itis pred t me or n Itative. APPUCANTNAME(PLEASEPRIW) Troy EStacio SIGNAT n,>E SVP Acquisitions & Development TAMID# 46-1325026 DWNEq ID N:O ACDOUW#: n� A661GNEO TO: PRM ACCOUNTING COMPLETED 6Y: SRTYPE PE Sc FEE INFO AMTREMITTED CHECK# REC7D BY DATE SERVICE REQUE 6 # INVOICE# 2903 523 $456.00 Work Plan 2904 523 $760.00 _ f y c (, Site Mitigation MFR 2-26-2096 A*WTRI,%A 7%1 �R��L�7�, =�-'�+ W� Cl-0AR1iZS L.AT:� 21-, AA2Lt-Sry4 � Q'LR/t'P't.i FT3)V G. iA-Nc =F`,r'P Zc7s0r/ d7N 4, { . C/tIF-,L�. Re"l IS THI9A NEW PROJECTLOOATIONt9p1 PREVIOUSLY REGULATED 9YTHE ENVIRON MENTAL HEALTH DEPARTMENT? YES ❑ No IJ ISTHISANEIDSTINGPROJECTLOCATION. SUTA NEW SCOPEOF WORK? YES Istl NO ❑ BUNNESdFAC1Uw1SRFJPRwEOTNAME Murphy Parkway APN 198-120-090 Sm ADORESSIPROIECTLOCATION PHON! BUSINESS 17100 Mur h P rkwa n/a CRY Lathrop STAN zip CA 95330 eDARDOrSUPERW9o11D19TRIDr LOMDONCODE KIWI KEY2 MAILINGADMESS.IFUIFFEIIEWFROMFAciuNAamE89 555 Capitol Mall, Suite 900 MAILINa ADDNE99Cm Sacramento BrAN CALP 85814 SICCDDE -- DUMMER: BUBINE88 NAME MAWNDADDRFS9 DO cm W � ACCOUNTADORE88 TO SEND F7EE9 AND OMAROES: OWNER® sraN C � ATTENNON FACILITY/BUSINESS❑ BILLING AND COMPLIANCF, ACKNOWLP,UChIEN'r: I, the undersigned Applicant, certify that I am the Owner, Operator, Auihoriyed Agent, or Respons/ble Party and I acknowledge that all PERMIT FEES, PENALTIES ENFORCEMENT CHARGES and/or HOURLY CHARGES associated with this project will be billed to me at the address identified above as the ACCOUNT ADDREss for this site. I also certify that all information provided on this application is true and correct; and that all regulated activities will be performed in accordance with an applicable SAN JOAQUIN COUNTY ORDINANCE CODES and/or STANDARDS and STATE and/or FEDERAL Laws and REGULATIONS. As the undersigned Owner, Operator, Authorized Agent, or Responsible Party for the project locate above cil4/1 address, I hereby authorize the release of any and all results, reports, and other environmental assessortin rmntion GJoAQDIN COI NTY ENVIRONMENTAL HEALTH DEPARTMENT as soon as it 9s available and at the same time itis pred t me or n Itative. APPUCANTNAME(PLEASEPRIW) Troy EStacio SIGNAT n,>E SVP Acquisitions & Development TAMID# 46-1325026 DWNEq ID N:O ACDOUW#: n� A661GNEO TO: PRM ACCOUNTING COMPLETED 6Y: SRTYPE PE Sc FEE INFO AMTREMITTED CHECK# REC7D BY DATE SERVICE REQUE 6 # INVOICE# 2903 523 $456.00 Work Plan 2904 523 $760.00 _ f y c (, Site Mitigation MFR 2-26-2096 A*WTRI,%A 7%1 �R��L�7�, =�-'�+ W� Cl-0AR1iZS L.AT:� 21-, AA2Lt-Sry4 � Q'LR/t'P't.i FT3)V G. iA-Nc =F`,r'P Zc7s0r/ d7N 4, { . C/tIF-,L�. Re"l