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08/26/2014 08:22 71493890 �K�LEY HORN PAGE 02/02 <br /> F., f1/ED ^ EHDIAGNUMBF <br /> SAN .JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> AUG 2 6 2014 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: v✓ww.sjgov.org/ehd <br /> ENVIRONMENTAL HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Jennifer Steen BUSINESS/AGENCY: 1Cimley-Horn mid Associates Inc. <br /> ADDRESS: 765 The City Drive,Suite 200 CITY/STATE/ZIP: Orange, CA 92868 <br /> PHONE(1): 71.4.705-1340 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 to arrange an appointment data and time to reviewthe requested records. <br /> CHECK BOX TO EXPEDITE REQUEST-$125 FEE,(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT pplE 8/25/14 <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City __ _ M'Unit1 <br /> 1. 2132 Mariosa Road Stockton f11 <br /> 2. 077 Sao, aa314, -q 3�/; 3.s 'File IL Unit2 <br /> 3. <br /> 4. c\/1l�t r pnit3 <br /> 5. <br /> s. A1�a <br /> a. <br /> ❑units <br /> 9, <br /> 10. <br /> /units <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> M UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ®MEDICAL WASTE FACILITY ®SOLID WASTE FACILITYIVEHICLE <br /> M OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ®WASTE TIRE <br /> ®UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ®DAIRY <br /> M ABOVEGROUND TANK ❑CHICKEN RANCH[DOD KENNEL ®WASTEWATER TREATMENT PLANT <br /> M HAZARDOUS WASTE]HAZARDOUS MATERIALS ❑MOTELIHOTEL ®PUMPER TRUCKNARDICHEMICAL TOILETS <br /> M TIERED PERMITTED FACILITY ❑POOLISPA ®LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING ®COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 5:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses In the space above. Select the type(s)of Nies from the list above by checking the appropriate <br /> box(es). At least one fife type MUST be selected. Eax to f209)464.0138 or mail to the address Indicated abov® 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 END files exist. An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The flies will be held fora 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$125 deposit prior to review. *"BOXED ARS-EHD USE ONLY"• <br /> ❑ Records provided by Staff-PPR Complete. staff Name: <br /> sHo 4e-oe <br /> mzana <br /> Received Time Au;. 26. 2014 8: 03AM No. 6904 <br />