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07/12/2010 11: 37 9168610430 STANTEC PAGE 02/02 <br /> Ifte <br /> DATE DECEIV�U ����D EHD LOG NUMBER <br /> G, SAN .10AQUIN COUNTY <br /> IIS ENVIRONMENTAL HEALTH DEPARTMENT <br /> JUL1 21,JIU 600 East Main Street, Stockton, CA 95202-3029 <br /> 1 elephone: (209) 468-3420 Fax: (209) 454-0138 Web: www.sj_qov.org/ehd <br /> 4 40 <br /> ENVIRONNIEN 1 HEALTH <br /> BLIC RECORDS RELEASE APPLICATION <br /> APPLICANT; Danielle Manning BUSINESSIAGENCY: Stantec Consulting Corporation <br /> ADDRESS: 3017 Kilgore Road- Suite 100 Cltylswtelzip Rancho Cordova, CA 95670 <br /> PHONE(1): (916) 384-0706 PHONE(2): (916) 251-4942 FACSIMILE: (916� 661-0430 <br /> TENTATIVE"APPOINTMENT DATE: July 20, 2010 Time: 10 00 am <br /> (P(oaso allow 10 business days from data of application submittal-'rentetive only_must be confirmed) <br /> © CHECK BOX TO EXPEDITE UEST-$10 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE -7 <br /> Electronic information: L] List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# __ Streot Namo City Unit 1 <br /> 1. 7647 Pacific Avenue Stockton <br /> 2. ❑ Unit z �\ <br /> 3. <br /> 4. Unit3 <br /> -6- — -- -- ----- Unit4 <br /> 7. <br /> _..___. ❑ Unit 6 <br /> O <br /> _. - ---- — ❑ Unit 8 <br /> 10- <br /> Specific Date Range of Information Requested:From 1955 to Present <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 1111 UNDERGROUND TANK,(UST)CLEANUP SITE(LOP) Cl HOUSING ABATEMENT ❑ SOLID WASTE FACILITYIVEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑WASTE TIRE <br /> UNDERGROUND TANK(MON ITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ® TIERED PERMITTED FACILITY M MOTEL/HOTEL ❑PUMPER TRUCKIYARD/CHEM TOILETS <br /> Q TATTOO/BODY PIERCING ❑ POOUSPA Q LAND USE APPLICATION SITES <br /> 7 MEDICAL WASTE FACILITY OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 8:00 AM-6:00PM - 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 (208)464-0138 or mail to the address indicated above Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. 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 he held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that Is actively being worked on by END staff may not be immediately available for review. A new application may be <br /> submitted when the file is available. <br /> 4. Any flip 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 $105 deposit prier to review. <br /> EHD USE ONLY <br /> @HO 48.08 5104'08 PUBLIC RECORDS RELEASE APP FORM <br />