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x a RECEIV'E�@I <br /> SQN :� QQQQ � � vironmental Health Department <br /> IN <br /> rsal`.: —COUNTY--- DEC 2 1 2017 k, PUBLIC RECORDS RELEASE APPLICATION <br /> -S S• rectoess arct,,s het"— 1 <br /> C ENVIRONMENTALHEALT� 2 77( <br /> PERM�RMES <br /> EHD LOG NUMBER: <br /> APPLICANT: Bailey BalShol BUSINESS/AGENCY: Partner Engineering and Science, Inc <br /> ADDRESS: 13$ L Street CITY/STATE/ZIP: Sacramento CA 95814 <br /> PHONE(1): 916-823-7555 PHONE(2): FAX OR E-MAIL: BBalshor()partnereSi.com <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will conte yo to a an a an appointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT DATE 12-21-17 <br /> 1. List up to ten addresses in the sp a below. Address ranges WILL NOT be accepted. Select the type(s)of files from the <br /> list below by checking the appropi'ate 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(cDsicehd.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 FILE ADDRESS <br /> HEALTH DEPARTMENT p y 9 accepted) EHD USE ONLY <br /> FILES (S ecific addresses only,address ranges will not be ecce ted <br /> IX7 Underground Tank(UST) Street# Street Name City <br /> X Cleanup Site(LOP) Elco su-MR <br /> ®Other Cleanup Site(Non-LOP) ' 930 East Charter Way Stockton <br /> ®Hazardous Waste E]DAM ,Nrt).V <br /> ®Tiered Permitted Facility 2 1 Jry pro M '9'YY�_ i"1 'r/1�L� ``A <br /> ©Aboveground Tank J `✓t' V� <br /> PM <br /> ®UST (Monitoring/Removal) V <br /> 3 <br /> ®Hazardous Materials <br /> ®Spill/Release Response Vd.QUAurr <br /> ❑Solid Waste Facility/Vehicle 4 <br /> ❑Food Facility _gyp <br /> Pool I Spa rte MmcnnoN r.J��11''�� <br /> Dairy 5 <br /> Land Use Application Sites <br /> ❑Septic Pumper Truck/ 6 1 <br /> Yard/Chemical Toilets <br /> ❑Wastewater Treatment Plant CUPA <br /> Housing Abatement r AST/HM/HW <br /> Motel/Hotel UPA <br /> ❑Chicken Ranch/Dog Kennel e UST <br /> El Medical Waste Facility <br /> ❑Tattoo/Body Piercing ❑Souo WASTE <br /> Waste Tire e <br /> Complaint <br /> Other(Please Specify): Acc "NG <br /> 10 <br /> —BOXED AREA-EHD <br /> ��USE ONLY;— <br /> ��7.1•• — — fu' CSF inµrP y K �'Wl �- <br /> ❑ Records provided by Staff-PPR Complete. sWffName: 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 />