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Rum: Lei hPa, ( ) To. Fax: +1 (209 4640136 Pae 2 of 2 10113/2016 8:00 PM <br /> DATE C SAN JOAQUIN COUNTY 9 EHD LOG NUMBER <br /> OCTNVIRONMENTAL HEALTH DEPARTMENT J / / `� <br /> � i `% ZUib 1868 East Hazelton Avenue, Stockton, CA 95205-6232 C_.11■ 1//'/y'',//, <br /> Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> cfiVlRGfur -sdTTALHEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> • iaF�'-�Ji�Jl�l'dTPs=S <br /> APPLICANT: Leigh Cloven BUSINESS/AGENCY: Pinnacle Environmental Inc <br /> ADDRESS: 10Ave. San Dimas, Unit B CITYISTATE/ZIP: an Clement—e-,-CA-9267-2- <br /> PHONE <br /> emente, A92672PHONE (1): 949)302-4404 PHONE (2);leigh(1iDei-env.c rl OR E-MAIL: $66)$45-4954 <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-$139 FEE(GASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT Leigh Cloven DATE October 13, 2016 <br /> 1. List up to ten addresses in the space below. Select the type(s)of files from the list below 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 some 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 $139 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From 01/01/1900 to 10/1�/7n16 <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS EHD USE ONLY <br /> (XUNDERGROUND TANK(UST) Street# Street Name City <br /> CLEANUP SITE(LOP) [D CONSUMER <br /> OTHER GFANUP SITE(NIDWLOP) 1 20 W. Turner Road Lodi <br /> YYYtttX HA2ARDW 5 WASTE CA RY <br /> TIERED PERMITTED FACILITY 2 <br /> ABOVEGROUND TANK <br /> DUST (MONFORINGIREMOVAL) ID PWS <br /> -X HAZNRDOus MATERIALS G <br /> p SPILLIRELEASE RESPONSE <br /> C®7 SOLID WASTE FACIUW/VEHICLE VJaTER GuuR`! <br /> 4 <br /> FOOD FACILITY <br /> F1 POOL I SPCA 61n[MIRGATION <br /> ❑DAIRY 6 <br /> ❑LAND USE APPLICATION SITES <br /> IX SEPTIC PUMPER TRUCK I E]HOUSING <br /> 6 <br /> Y.^RD ICHEMI6.4 TOILETS <br /> WASTEWATER TREATMENT PUNT OUPA <br /> ❑HO'J61NG ABATEMENT y <br /> ❑MOTELMOTEL <br /> CHICKEN RANCH/DOG KENNEL C'JPA -IST <br /> MEDICAL WASTE FACILITY B <br /> ❑TATTOOIBODY PIERCING SOuo VAxTE <br /> ❑WASTE TIRE <br /> IX 9 <br /> COMPLAINT <br /> ❑OTHER(PLEASE SPECIFY): A..NTNG <br /> 10 <br /> —BOXED AREA-EHD USE ONLY' <br /> TOTRecord�sprovided by Staff-PPR Complete. staff Nam.: <br /> Received Tlme-Oct. 13. -2016' 7 : 51PM'No. 0158 <br />