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1% RECEIVED <br />SAN J OAQ U I N I Environmental Health Department <br />0 U N T Y �y� i + PUBLIC RECORDS RELEASE APPLICATION <br />r/J dol <br />• ! �� , e I v r 1, a rEGV'VIQPAu! i` i�k� 3Q l' <br />AIL <br />PERMIT/ �" 1r EHD LOG NUMBER: <br />C <br />• <br />APPLICANT: Reena Paleja (Broker)/ Gurmeet Dabb (Buyer) BUSINESS/AGENCY: Quicki Kleen Car Wash <br />ADDRESS: 707 E Yosemeti Ave CITY/STATE/ZIP: Manteca <br />PHONE (1): (415)866-3440 PHONE (2): (510)846-2194 FAX OR E-MAIL: rpaleja@gmail.com <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 DATE o 0 '01;', <br />1. 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 info a()slcehd.com. Applications received after 3:00 pm will be processed the next <br />business day. <br />2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted below. <br />3. 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 />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 $152 deposit prior to review. <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) '7 <br />Electronic Information: x❑ List X❑ Map — Description: <br />Specific Date Range of Informatio uested: From to <br />ENVIRONMENTALFILE <br />HEALTH DEPARTMENT <br />140\8% <br />ADDRESS <br />C'0 4 j16 <br />FILES <br />` <br />( I <br />e ses only, address ranges will not <br />y 9 <br />accepted) <br />be acce ted <br />EHD USE O N L <br />x� Underground Tank (UST) <br />Street # <br />Street Name <br />City <br />1 <br />707 <br />E Yosemite Ave <br />Manteca <br />ON SUN. <br />Cleanup Site (LOP) <br />Q Other Cleanup Site (Non -LOP) <br />0 Hazardous Waste <br />❑ DAIRY <br />n Tiered Permitted Facility <br />2 <br />Q Aboveground Tank <br />❑ PWS <br />nX UST (Monitoring / Removal) <br />Q Hazardous Materials <br />3 <br />0 Spill I Release Response <br />KIDS <br />ATER QUALITY <br />F-1 Solid Waste Facility I Vehicle <br />4 <br />FX Food Facility <br />OR'S"TE MITIGATION <br />Pool / Spa <br />Dairy <br />5 <br />U Land Use Application Sites <br />❑ HOUSING <br />U Septic Pumper Truck / <br />6 <br />Yard / Chemical Toilets <br />Wastewater Treatment Plant <br />CUPA <br />Housing Abatement <br />7 <br />AST I HM / HW <br />❑ Motel/Hotel <br />11 <br />CUPA <br />Chicken Ranch / Dog Kennel <br />❑ Medical Waste Facility <br />g <br />UST <br />Tattoo/Body Piercing <br />❑ SOLID WASTE <br />Waste Tire <br />9 <br />Complaint <br />❑ AccouNTING <br />❑ Other (Please Specify): <br />10 <br />—BOXED AREA - EHD USE ONLY** <br />t.��J^,rvz� v <br />i <br />!1 <br />❑ Records provided by Staff -PPR Complete. st ff Name: EHD 48-06 <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />