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EHD LOG NUMBER <br /> DATE RECEIVED (y A' SAN JOAQUIN COUNTY <br /> I,� t 1 NVIRONMENTAL Pff H DEPARTMENT ���yyy <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 \ 1 <br /> J tQ` Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd Ifl <br /> 6g <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:Terry Nephew tnephew@kleinfelder.com BUSINESSIAGENCY:Kleinfelder <br /> ADDRESS: 5125 N. Gates Ave., Ste 102 CITYISTATEIZIP:Fresno, CA 93722 <br /> PHONE (1): 559-577-1459 PHONE (2):559-647-3842 FACSIMILE:559-442-5081 <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQU ST-$12b FE CASH R CH CK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT i/U tG� DATE <br /> Electronic Information: ❑ List❑ Map--Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name city <br /> 1. 400 East Main St. Stockton M o %( <br /> 2. 47 South San Joaquin St. Stockton HM/vl ❑ unit z <br /> 3. 236 East Miner Ave. Stockton (Jo IW'A 3 ( ho CO(� <br /> 4. 700 East Market St. Stockton , <br /> Jilt I,o Unit 3 Ia <br /> 5. 400 South Aurora Stockton ury fO t)(t0 0 tiwE CD <br /> 6. 521 East Main Stockton p ,/U9 �( P L.0 (�Clnit4 I� <br /> 632 South El Dorado Street Stockton _tQl®a <br /> 8. 423 North Madison Stockton o - t�/ ❑Unit 5 <br /> 9. 402 West Weber Ave Stockton Uh 7 my No (p/.gp <br /> 10. 140 1 Lincoln Street ub100 1 N0Cod ❑units <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACrIL�ITYNEH/IIC-LE „I 3 <br /> ®OTHER CLEANUP SITE(NON-LOP) El HOUSING ABATEMENT ❑WASTE TIRE �r,/Q 5 rUr <br /> ®UNDERGROUND TANK(MONITORINGIREMOVAL)(IJ l ❑FOOD FACILITY ❑DAIRY 0i Ga to- -7-1 <br /> ®ABOVEGROUND TANK a>L ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> ®HAZARDOUS WASTE/HAZARDOUS MATERIAUpE- ❑MOTELIHOTEL ❑PUMPER TRUCK/YARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC Pr -"/(/Yx-rd-- LOo(7 py D y3(rpt 51D 0 in tT-W fi Ie . (CLUDING HOLIDAYS) <br /> 1. List up to ten add 400 MzUel- 0' (,a002(PLdy 1 the appropriate <br /> box(es). At least( W-L,O,orb 5, fe cerp+ 1•,O/x dewy up) i n U"F-r,� ad above. Address <br /> ranges will not be l DD 35 .,(30Pq 5/Oro)� co©D 35 a 05(If-t­5106 a ons received after <br /> m <br /> 3:00 pwill be pry ym ID//�O/Zt DCOi(0/gq Die-)0 A CD441trcM <br /> e" W A/r✓ <br /> 2. The EHD willnotif (f 51p(odCDOaay l(f'PI`SpJa^'�I" Ipproximatelyten(10) <br /> days after receipt (o3J E I OJrra�O- �1p2�$ `� , Q3J$7(�"np(o5 e e Q MY} y. Appointments <br /> should be schedu +io HIA) (-I/t' F0�/P�D S/LI�tIS. (0� <br /> W 003d(pC�7 if f S l0 ° 3/Zo/b 01 �� ` n - w application may be <br /> 3. A file that is active d- Q pp Y <br /> submitted when t1 F (pr PXC:2 Dcl3- i C,1lQ.�� * <br /> 4. Any file not returr Lr to /1'Id_sDII^''' I''� 05�q�r�S10(0 n �' ^'tea ' se of the applicant. <br /> Future file review: Uy T (i K• !cant may require a$125 deposit prior to review_ ***BOXED AREA-EHD USE ONLY... <br /> 1 0�1"L <br /> n Kg 0 - • (1, 97- ct pPl wri t Lu1ctA.:a►� X21 ky I i w;f i 11!t� Frie ;s P,� o v t# o <br /> :W <br /> F"n" . 12119112 <br />