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3 06/"6/20172:58 PM 14159529421 >12094640138 <br /> DEHD LOG NUMBER <br /> ATE RECEIVED <br /> i�ECEIVE�I1 SAN .JOAQUIN COUNTY <br /> d ENVIRONMENTAL HEALTH DEPARTMENT ?Q61112M <br /> JuN 2017 Te05-6232 <br /> leph1868 East Hazelton one: (209) 468-3420 Fax: 2(209) 464-0138 Webenue, Stockton, CA 5wwwjgov.org/ehd <br /> ',—,NVIRONMENTALH <br /> PERMIN RW'FREALTH PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Brian Kim _____ __BUSINESS/AGENCY: Partner Engineering & Science, Inc. <br /> ADDRESS: 111 Pine Street, Suite 1750 _ _ _ CITY/STATE/ZIP: San Francisco,CA 94111 <br /> PHONE (1): (415)680-8953 PHONE (2): FAX OR E-MAIL: bkim@partneresi.com <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 /> Q CHECK EOXTO EXPEDITE REQUE&6 $130FM�(CASH,OR CHECK ONLY) REQUEST PROCESSED IN3SUSINES$PAY' <br /> SIGNATURE OF APPLICANT -- — DATE June 6, 2017 <br /> Electronic Information: ❑ List❑ Map–Description: <br /> FILE ADDRESS u EH d use ONLY <br /> Street p Street—Name city <br /> 1 2244 West I ane Stockton <br /> 2. AIOW � <br /> 3. 0 <br /> 4. Wa+fi: w jl� <br /> 5. - <br /> 6. <br /> � T• 'Nf'I�NI. <br /> $- SITE MITIGATION <br /> 9. SaU�1./�Ytt <br /> 10. <br /> Specific Date Range of IMomedon Requested: From All to All _ <br /> ENVIR0141111E. /U EALTH DEPARTMENT'F1pf5 <br /> Q UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 MOTELIHOTEL ©SOLID WASTE FAGLrrYNEHtcLE <br /> O OTHER CLEANUP SITE(NON-LOP) Q HOUSING ABATEMENTX❑FOOD FACILITY <br /> Q UNDERGROUND TANK(MONITORINGIREMOVAL) Q WASTE TIRE Q DAIRY,POOLISPA <br /> Q ABOVEGROUND TANK Q CHICKEN RANCH/DOG KENNEL Q WASTEWATER TREATMENT PLANT <br /> QX HAZARDOUS WASTE Q MEDICAL WASTE FACILITY Q PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> Q HAZARDOUS MATERIALS TATTOO/BODY PIERCINGX❑LAND USE APPLICATION SITES <br /> X❑TIERED PERMITTED FACILITY Q COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY$:00 AM-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. 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$130 deposit prior to review. <br /> "*BOXED AREA-EHD USE ONLY*** <br /> n 0__. A_ 7r....14..A b.,ee9fe-000 r .....t..e.. Staff Name: <br /> Received Time=Jun. 6. _2017_ 2. 54PIv1°N71629 <br />