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DATE RECEIVED � MBER <br /> SAN JOAQUIN COUNTY f IL E �� <br /> ENVIRONMENTAL HEALTH DEPARTMENTi <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> •1 Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Kristen Rini BUSINESS/AGENCY: IPM Environmental <br /> ADDRESS: 13400 Douglas Boulevard, Suite 200 CITY/STATE/ZIP:lRoseville,CA 95661 <br /> PHONE (1): (916)945-3778 PHONE(2): (330)221-3440 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 date and time to review the requested records. <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT jKristen Rini I DATE 5/14/2014 <br /> Electronic information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑Unit 1 <br /> [44. <br /> 1415 West Anderson Street Stockton820 South Pershing Avenue �6�� p unit 2 <br /> f 1505 Navy Drive G 21 Unit 3 <br /> 5. 1111 Navy Drive r — — <br /> 6. O Unit 4 <br /> 7. <br /> 8, ❑ Unit <br /> L <br /> I 12,Knit 6 <br /> r <br /> Specific Date Range of Information Requested: From 1900 to Present ) <br /> 196 <br /> ENVIRONMENT L HEALTH DEPARTMENT FILES <br /> (I�JV//UNDERGROUND TANK(UST)CLEANUP SITE(LOP) <br /> ENVIRONMENT <br /> WASTE FACILITY OLID WASTE FACILITYIVEHICLE <br /> [VO'THER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ASTETIRE <br /> Eq UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑ IRY <br /> ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL STEWATER TREATMENT PLANT <br /> AZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL MPER TRUCKIYARDICHEMICAL TOILETS <br /> IERED PERMITTED FACILITY ❑ OOLISPA NO USE APPLICATION SITES <br /> F-1TATTOOIBODY PIERCING COMPLAINTIRESPONSE RECORDS THER(PLEASE SPECIFY)LCArdS OfmentalWELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY H:OO AM-S:OOPM(EXCLUDING n <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 It 0) <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$125 deposit prior to review. ***BOXED AREA-EHD USE ONLY*** <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> aaena <br /> EHD 48-06 <br />