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E& SANIOAQUIN RECEIV wonmental Health Department <br />COUNTY MAY 1 5 2018 PUBLT RECORDS RELEASE APPLICATION -- <br />Cr , <br />APPLICANT: Alvaro Dominguez BUSINESS/AGENCY: Partner Engineering and Science <br />ADDRESS: 1017 22nd Avenue Suite 107 CITY/STATE/ZIP: Oakland California 94606 <br /> <br />PHONE (1): 650-996-2876 PHONE (2): FAX OR E-MAIL: alvarc_dominguez@live.com <br /> <br />Please allow 10 business days from date of application submittal for the records to be available. <br />Staff will contact you to arrange an appointment date and time to review the requested records. <br />SIGNATURE OF APPLICANT Alwiro Dominguez DATE i <br />List up to ten addresses in the space below. 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 infoasicehd.com. Applications received after 3:00 pm will be processed the next <br />business day. <br />For assistance in identifying the nature and content of EHD records, please contact END at the number noted below. <br />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 />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-5:00PM (EXCLUDING HOLIDAYS) <br />Electronic Information: El List Map - Description: <br />Specific Date Range of Information Requested: From to <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />FILES <br />FILE ADDRESS <br />(Specific addresses only, address ranges will not be accepted) <br />-C.,(7) V la 12511Y <br />EHD USE ONLY <br />Ili Underground Tank (UST) <br />Cleanup Site (LOP) <br />Street # Street Name City <br />1 1250 South Wilson Way # B-10 Stockton <br />ND005 1 Co 0 CONSUMER <br />El Other Cleanup Site (Non-LO <br />ei Hazardous Waste <br />2 1250 South Wilson Way Stockton <br />0 DAIRY <br />CD <br />AST iffilEei thg? CO) sp (4) <br />111 Tiered Permitted Facility <br />E3 Aboveground Tank <br />3 <br />çç <br />I\ 1/1-ii\ 1- 61 0-ki tik171' <br />0 PWS im UST (Monitoring / Removal) <br />El Hazardous Materials <br />El Spill / Release Response <br />4 <br />WATER QUALITY <br />El Solid Waste Facility / Vehicle <br />I. Food Facility <br />5 <br />ESTIE MITIGATION . Pool / Spa <br />. Dairy <br />. Land Use Application Sites <br />6 <br />0 HOUSING <br />--- <br />I. Septic Pumper Truck / <br />Yard / Chemical Toilets <br />. Wastewater Treatment Plant <br />7 <br />Ka'CUPA <br />AST / HM /HW In Housing Abatement <br />. Motel/Hotel <br />8 <br />SY6-UPA <br />UST <br />. Chicken Ranch / Dog Kennel <br />. Medical Waste Facility <br />111 Tattoo/Body Piercing <br />9 <br />Itif...OLID WASTE <br />. Waste Tire <br />in Complaint <br />111 Other (Please Specify): <br />10 <br />0 ACCOUNTING <br />**"BOXED AREA - EHD USE ONLY*** <br />,•"1-,,;;1k,\ Nat 6;Ai1A-N4 tea:,i:,k 0 -i Pg10,L4.0,r-.ri a iiel,,,,A. cl„,'. idd,i;ve_ -c-itt)c. 000., i— <br />cf2/ Zs) le : %acti2c1 uncuicciak/at,1 kr2-41e-r for PR GEl-/-`194' / (WU.) Le. AD Lick rctir toe : c000Litew-i (Rept+ 5100 i 1 thru 51p PP,051,c6-7, iMiti enD01112S. IZpi- IDto ,35 -64(124- rttvOcktioLL <br />0 Records provided by Staff-PPR Complete. Staff Name: inc.! urlici fir-CO 0002H21, QektantMtri coaso-A.. 48-06 ciLcurne ntc <br />ei.)002 /ma, m0093711.0 /. Atr ,c000liqz, 7 5 in VP 5Los.,, RINICied Ckrn CD <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.'s'jcehd.com <br />PA/In pvl (alq 1Cie , EkviRoNmEIN-Ariquifftt IL 6,-{ EHD LOG NUMBER: PERMIT 'ERVICES