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DATE RECEIVESAN /" Imo' • EHD LOG NUMBER <br />.JOAQUIN COUNTY <br />0" ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 / <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />llJ PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: JOANNA TIPPETT <br />BUSINESS/AGENCY: URS CORPORATION <br />ADDRESS: 12420 MILESTONE CENTER DRIVE, SUITE 150 CITY/STATE/ZIP: GERMANTOWN, MD 20876 <br />PHONE (1): 301-820-3000 <br />PHONE (2): <br />FACSIMILE: 301-820-3009 <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 />❑ CHECK BOX TO EXPEDITE REQ T- $125 FEE (CASH O <br />R/CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANTDATE 6123/14 <br />Electronic Information: ❑ List ❑ Map - Description: <br />FILE ADDRESS <br />EHD USE ONLY <br />IUnitl <br />Street# <br />Street Name City <br />11. <br />22221S <br />SINCLAIR STOCKTON <br />1. A li+v, W? <br />n n <br />❑ Unit 2 <br />2. <br />3. <br />M Unit 3 <br />4. <br />5. <br />® Unit <br />6. <br />7. <br />❑ Unit 5 <br />8• <br />9 <br />❑ Unit 6 <br />10.. <br />Specific Date Range of Information Requested: From ; :,�[�` (, �( to G71 1 (iL,V,g2t <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />® UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ MEDICAL WASTE FACILITY [:]SOLID WASTE FACILITY[VEHIGLIE <br />® OTHER CLEANUP SITE (NON -LOP) ❑ HOUSING ABATEMENT ❑ WASTE TIRE rrVV//11 TT((TT rp f-; s, - <br />® UNDERGROUND TANK (MONITORINGIREMOVAL) tP ❑ FOOD FACILITY ❑ DAIRY V2, —/'-I <br />® ABOVEGROUND TANK Z74 ❑ CHICKEN RANCHI DOG KENNEL ❑ WASTEWATER TREATMENT PLANT <br />® HAZARDOUSWASTEIHAZARDOUS MATERIALS O`— ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARDICHEMICAL TOILETS <br />❑ TIERED PERMITTED FACILITY ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br />❑ TATTOOIBODY PIERCING ❑ COMPLAINTIRESPONSE RECORDS ❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:00PM (EXCLUDING HOLIDAYS) <br />1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checking the appropriate <br />box(es). At least one file type MUST be selected. Fax to (209) 464-0138 or mail to the address indicated above. Address <br />ranges will not be accepted. Applications received after 3:00 pm will be processed the next business day. <br />2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted above. <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 $125 deposit prior to review. ***BOXED AREA - EHD USE ONLY*** <br />5=� <br />i <br />11 ❑ Records provided by Staff -PPR Complete. Staff Name: 11 <br />