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05/18/2016 4 : 14: 35 PM --0400 FAXCOM ANYWHERE PAGE 3 OF 3 <br /> DA E C IV � EHD LOG NUMBER <br /> 0 0 V "fir SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> E 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> i <br /> a 20klephone: (209) 468-3420 Fax: (209) 464-0138 Web: vwvw.sjgov.orglehd <br /> E ERCNMEIMTA.L t EALni <br /> IT PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Amanda Benbow BUSINESS!A`sENCY: P€+.4 Environmental Inc. <br /> ADDRESS: 3400 Douglas Blvd Suite 200 CITYISTATE2IP: Roseville, CA 95661 <br /> PHONE(R): (916) 472-2870 PHONE (2): FACSIMILE: (877) 884-6775 <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> CHECK BOX TO EXPEDITC1UES - 130 FELASH OR CHECK ONLY)-REQUES�PROCESSED!N 3 BUSRNESS DAYS <br /> SIGNATURE OF APPLICAN n DATE <br /> Electronic Inforrnation: ❑ List ❑ Map-Description: <br /> FILE ADDRESS - EHD USE ONLY <br /> Street# Street Name city U23y ❑Unit 1 <br /> 1. 760 Industria! Drive Stockton J U-1 Tc Z-'/40�5 J <br /> 2. 950 Industrial Drive Stockton 6SU 9 4 y Q Unit 2 <br /> 3. Go!; -, <br /> 4. Ld Unit 3 1 <br /> 5. <br /> V. <br /> Jui <br /> T. <br /> 8. <br /> Q Unit 5 <br /> 9. <br /> 10. <br /> El 144FG— <br /> Specific Date Range of Information Requested: From Any and All to Any and All <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLFANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACIL TY[VEHICLE <br /> ❑OTHER CLEANUP SITE(KION-LOP) E]HOUSING ABATEMENT ❑WASTE TIRE ���Q�� �CC <br /> ®UNDERGROUND TANK(MONITORINGIREM OVAL) ❑FOOD FACILITY ❑DAIRY r✓ rr" <br /> ❑ABOVEGROUND TANK ❑CHICKEN RANCHI DOG KENNEL ❑WASTEWA REATMENT PLANT <br /> HAZARDOUS WASTEIHAZARDOUS MATERIALS rT. ❑MOTFLIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOLISPA ❑LANES USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING ❑COMPLAINT/RESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 ANI-5:00PM (EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select 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 number noted above. <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. Anyfile 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$130 deposit prior to review. —BOXED AREA- EHD USE ONLY*** <br /> l <br /> ❑ Records provided by Staff-PFR Complete. staff Name: <br /> °B'°'"4 <br /> Received Time May. 10. 2016 1 : 14PM No. 0810 <br />