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RECEIVED <br /> SAN J O A Q U 1 N 3UIN 0 4 2038 Environmental Health Department <br /> C O U N T Y------ PUPLIC RECORDS RELEASE APPLICATION <br /> • REMNIM,'.` &ES A(A EHD LOG NUMBER: <br /> APPLICANT: Bailey Balshor BUSINESS/AGENCY: Partner Engineering and Science, Inc <br /> ADDRESS: 1544 Eureka Road, Suite 180 CITY/STATE/ZIP: Roseville, CA 95661 <br /> PHONE(1): 916-823-7555 PHONE(2): FAX OR E-MAIL: BBalshor(a�partneresl.com <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact,yov to afrange an appointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT ,I')alb"i ���irf��b0 DATE 5-31-2018 <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 infona 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) <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> ( P Y 9 p ) EHD USE ONLY <br /> FILES (Specific addresses onlyaddress ran es will not be acce ted <br /> ❑X Underground Tank(UST) Street# Street Name city <br /> X Cleanup Site(LOP) T5 IIvyZ (4otS❑CONSUMER <br /> ®Other Cleanup Site(Non-LOP) ' 1422 West Colony Road Ripon 11M 1-�U�i1�4• _u _®Hazardous Waste ❑DAIRY <br /> ®Tiered Permitted Facility � 2 1442 West Colony Road Ripon / / <br /> Q _Aboveground Tank A l NpM,111✓V% povit(66 j�R6V' V <br /> ®UST (Monitoring/Removal) ❑PwS <br /> ®Hazardous Materials 3 <br /> ®Spill/Release Response <br /> ❑Solid Waste Facility/Vehicle 4 WATER QUALITY <br /> ❑Food Facility <br /> Pool/Spa SITE MITIGATION <br /> Dairy 5 <br /> ❑ Land Use Application Sites <br /> ❑Septic Pumper Truck/ ❑6 HOUSING <br /> Yard/Chemical Toilets <br /> F]Wastewater Treatment Plant (CUIA <br /> ❑Housing Abatement 7 AST I HM/HW <br /> ❑Motel/Hotel <br /> Chicken Ranch/Dog Kennel CUPA <br /> Medical Waste Facility 8 UST <br /> ❑Tattoo/Body Piercing <br /> F-1WasteTire El SOLID WASTE <br /> 9 <br /> ij Complaint <br /> Other(Please Specify): I]ACCOUNTING <br /> to <br /> ***BOXED AREA-EHD USE ONLY <br /> • �(-i - -F-u T l< ' 4,>b_E� t ,:4 P.R , ;,n j .-N _,t Iwe <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: EHD48-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209464-0138 1 www.sjcehd.com <br />