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0 -0,1O0 FAXICOM A02WIi?-RE PAGE �5 O? �3 <br /> = -- <br /> . sHoLOG NUMBER <br /> ~�' -� SAN [OAQU/N COUNTY <br /> ' - � 3 ENVIRONMENTAL HEALTH DEPARTMENT <br /> iWRON�ENVHE4LTH'1868 East Hazelton Avenue, Stockton, CA95205-6232 ` <br /> e� /2OS\ 468-342OFaz� (2OS\ 4�4-D13� V�eb� \w/wv �goV�urg/ehd <br /> r�� , , ,� ' www.sigov.org/L-hd <br /> ��R�\\���o��« <br /> PU B| |C RECORDS RELEASE APPLICATION <br /> APPLICANT: AmendaBanbow BUSINESS/AGENCY: PM Environmental Inc. <br /> ��DO�E�3� 54OODoug|aoB|vdBuite2OO C|TYIST��TE��(p: Roseville, CA85OO1 <br /> PHONE(1): PHONE (2): FACSIMILE: <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you date and time to reviewthe d records. <br /> L] CHECK BOX ToEXPEDITE REQUESTHECK PROCESSED|msBUSINESS DAYS <br /> SIGNATURE OFAPPLICANT DATE ju| 14 2D16 <br /> FILE t;DDRESS EHD USE ONLY <br /> Street# Street Name City F] Unit I <br /> 4445 North Pershing Ave Stockton <br /> 4444 North Pershing Ave Stockton <br /> North Pershing Ave Stockton <br /> 4501 /0,190/00 <br /> 4. 4555 North Pershing Ave Stockton OWN /CV i Unit 3 <br /> 7. <br /> El Unit 5 <br /> Unit 6 <br /> Specific Date Range ofInformation Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> FX UNDERGROUND TANK(UST)CLEANUP SITE(LOP) F MEDICAL WASTE FACILITY SOLID WASTE FAc|LR7[VEx|cLE <br /> DTxsnCLExNuPSITE(Now'LOP) F HOUSING ABATEMENT WASTE TIRE <br /> UNDERGROUND TANK UNownomwo/RsmuuAL\ FOOD FACILITY DAIRY <br /> ABOVEGROUND TANK CHICKEN RANCH/DOG KENNEL WASTEWATER TREATMENT PLANT <br /> HAZARDOUS VVAoTdHxzxn000nMATERIALS 7 0oTsdHnTsL PUMPER TRucxyYmm/Cxsm/cAiTOILETS <br /> TIERED PERMITTED FACILITY 7 PooUGpx LAND USE APPLICATION SITES <br /> TxTrno/BooYP|snc!wo [|ComPuuwT/RsnpuwosRECORDS []OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 Am-5:00pm (EXCLUDING HOLIDAYS) <br /> I. List up to ten addresses in the space above. Seiect 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 num ber noted above. <br /> n. The EMDwill notify the applicant ifany EHofiles exist. Anappointment for review will beconfirmed approximately ten (1o) <br /> days after receipt ofapplication. The files will heheld for amaximum offive business days for review. Appointments <br /> should bescheduled accordingly. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff atthe expense of the applicant. <br /> Future file reviews by the same applicant may require a$130 deposit prior to review. ~^~ AREA- EHDUSE ~° <br />