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1■ From IVI Assessment Services Inc 1.925.626.4020 Tue Jan 27 11:21:48 2015 MST Page 1 of 1 <br /> 'N■DATE RECEIVED EHD LOG NUMBER <br /> 'on <br /> SAN JOAQUIN COUNTY <br /> I� RNE <br /> 149tj ENVIRONMENTAL HEALTH DEPARTMENT <br /> ■■ <br /> JAN 2:7 .2015 1868 East Hazelton Avenue, Stockton, CA 95205-62321 <br /> i ;Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br /> ENVfRONMENTAI" lV" PUBLIC RECORDS RELEASE APPLICATION <br /> �1S <br /> APPLICANT: Ryan McDaniel BUSINESS/AGENCY: IVI Assessment Services <br /> ADDRESS: 3715 Lincoln Avenue#3 CITY/STATE/ZIP: Oakland, CA 94602 <br /> PHONE (1): 925-354-1686 PHONE (2): FACSIMILE: 925-626-4020 <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 REQUEST-$130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT RM DATE 1/27/2015 <br /> Electronic Information: ❑ List❑ Map–Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑Unit 1 <br /> 1 1111 1st Street Escalon Nl _ <br /> y� 2. 1905 McHenry Ave Escalon S ki) ❑Unit 2 ) t <br /> 3. Gong wH ♦� <br /> 4' 0 Unit 3 VI <br /> 5. <br /> 6. [2/Unit 4 <br /> 8. ❑Unit 5 <br /> 9. <br /> 10. <br /> ❑Unit 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> Q UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILITYNEHICLE pr <br /> X❑OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> Q UNDERGROUND TANK(MONITORING/REMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> Q ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> X❑HAZARDOUS WASTE/HAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCK/YARD/CHEMICAL TOILETS <br /> Q TIERED PERMITTED FACILITY ❑POOL/SPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOO/BODY PIERCING 0 COMPLAINT/RESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(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$130 deposit prior to review. —BOXED AREA-EHD USE ONLY— <br /> ��r1 1�Ll7A i 5 ,v% '��� 14e . ee f�, p-(Part. <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> Rece-ived Time Jan. 27. 2015 10: 14AM No. 7964 0810 <br /> 1/ <br /> 1 <br /> 4 <br />