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03/09/2011 14:38 FAX 9546770591 PINNACLE EMS 0 001 E G EW e EHD LOG NUMBER SAN .�OAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT O 9 lO�j 600 East Main St. Stockton, CA 95202-3029 Telephone: (209) 468-3420 Fax: (209) 464-0133 Web: www.sjgov.Drg/ehd ENVIRONMENTAL HEAD H 0 PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION APPLICANT: Rosanna Del Castillo BUSINESS/AGENCYPinnacle Environmental Management nupport ADDRESS: ;.zoo park Centra? Blvd South, suite 1400 CITY/STATE/ZIP: Pompano Beach, FL 33064 PHONE(1): (954) 977-3775 ext 1Q$ PHONE (2): FACSIMILE: (954) 977-3875 TENTATIVE" APPOINTMENT DATE: Time: (Please allow 10 business days from date of application submittal - "Tentative only - must be confirmed) ❑ CHECK BOX TO EXPEDITE REQUEST- $122 FEE (CASH OR CHECK ONLY) . REQUEST PROCESSED IN 3 BUSINESS DAYS SIGNATURE OF APPLICANTS W&W� DATE 03/09/11 Electronic Information: ❑ List ❑ Map— Description: wo FILE ADDRESS EHD USE: ONLY ❑ Unit 1 Street # Street Name City r2. Hardin Way E Stockton U��i O Unit 2 copy o e rs perms a o a A cop of t e 1992 and 1993 UST operating permit e o own or opera issued b the local a gency prior to removal of the UST's Un 3� 4, 5. Unit4 6. 7. El Unit 6 $. 9. El Unit s 10. Specific Date Range of Information Requested: From to ENVIRONMENTAL- HEALTH DEPARTMENT FILES ® UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITYIVEHICLE ❑ OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY ❑ WASTE TIRE ❑ UNDERGROUND TANK (MONrrORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY ❑ HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ WASTEWATER TREATMENT PLANT ❑ TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCK/YARD/CHEMICAL TOILETS ❑ TATTOOBODY PIERCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES ❑ MEDICAL WASTE FACILITY ❑ OTHER (PLEASE SPECIFY) WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 ANI-5:00PMI (EXCLUDING HOLIDAYS) 1. List up to ten aditissps in the space above. Select the type(s) of files from the list above by checking the appropriate box(es). At least one file type MUST be selected. Fax to 1209) 464-0138 or mail to the address lndlcated above. Address ranges will not be accepted - for additional assistance with file addresses, contact the EHD. Applications received after 3:00 pm will be processed the next business day. 2. The EHD will notify the applicant If any EHD files exist. An appointment for review will be confirmed approximately ten (10) days after recelpt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. 3. A file that Is actively being worked on by EHD staff may not be Immediately available for review. A new application may be submitted when the file Is available. 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the expense of the applicant. Future file reviews by the same applicant may require a $122 deposit prior to review. EHn 115E ONE Y f�i��i�i�!_ ��i�:�l��ii " " � �..�'� .►moi JIj'� wo Lim�i/.�+r�i �� w/1! i / /i i / ✓ . f . X911 i I in M, �_ ��j �I iErlo 48-0t ' i 9 c— 1 F I I i zw EMU