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07/14/2016 0400 FAXCOM ANYWHERE PAGE 3 OF 3 <br /> DATER VED EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> a ENVIRONMENTAL HEALTH DEPARTMENT � <br /> RONMEN7ALHEALIt$1868 East Hazelton Avenue, Stockton, CA95205-6232 <br /> • EN IR&IPERMITfoE SCE -3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> ne: (209) 468 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Amanda Benbow BUSINESS/AGENCY: PM Environmental Inc. <br /> ADDRESS: 3400 Douglas Blvd Suite 200 CITY/STATE/ZIP: Roseville, CA 95661 <br /> PHONE(1): ((916) 472-2870 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 app tmentd ate and time to review the requested records. <br /> ❑ CHECK BOX TO EXPEDITE REQUEST $1 0 FEE H OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE July 14, 2016 <br /> Electronic Information: ❑ List ❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City E] Unit 1 <br /> 1. 4445 North Pershing Ave Stockton t�fU -Re.,(b^ —LO <br /> 2. 4444 North Pershing Ave Stockton Unit2 Of�Z`)✓ <br /> 3. 4501 North Pershing Ave Stockton / <br /> 4• 4555 North Pershing Ave Stockton prO J6,CO (y Unit 3 <br /> 5. oblvn rit�3 <br /> A <br /> 8. ❑ Unit 5 <br /> 9. <br /> 10. ❑ Unit 6 <br /> Specific Date Range ofinformatlon Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 0 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACIUTYNEHICLE <br /> ❑OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> ®UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ®ABOVEGROUND TANK ❑CHICKEN RANCHI DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> X❑HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑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 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 (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. —BOXED AREA- EHD USE ONLY"` <br /> tRecords provided by Staff-PPR Complete. Staff Name: <br /> Received081071 <br /> Time Jul. 14. 2016 2: 58PM No. 0974 <br />