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00/6//22t0�177 5:20 PM 14159529421 )12094640138 n 1 <br /> $ • 01E1V�0 SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> �■ SEP O 7 2017 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.orglehde7o52.��fi15r,aNmW�IDES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: David Gerhardstein BUSINESS/AGENCY: Partner ESI <br /> ADDRESS: 111 Pine St, STE 1750 CITY/STATE/ZIP: San Francisco, CA 94111 <br /> PHONE(1): 415 - 599 - 1184 PHONE (2): FAX OR E-MAIL: <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 /> [I CHECK B0(TOEXPEDf7E REQUEST-$130 FEE(CASH OR CHECK ONLY):.-.REOUEST;PROCESSEIl IN 3 BUSINESS(JAYS <br /> SIGNATURE OF APPLICANT dgerhardstein@partneresi . com DATE September 6, 2017 <br /> Electronic Information: ❑ List ❑ Map-Description: <br /> FILE ADDRESS <br /> EHD USE ONLY <br /> Street If Street Name City <br /> 1' 717, South San Joaquin Street Stockton �tAh <br /> 2. <br /> 3. <br /> 4. CLkDA- NST) <br /> 5. <br /> 6• z Mitl' }U�1 <br /> 7. <br /> 8. <br /> 9. IIJILd l <br /> 10. I &0 Wry �C W <br /> Specific Date Range of Information Requested: From uu to <br /> ENVIRONMENTAL'HEALTH DEPARTMENT FILES <br /> ❑X UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MOTELIHOTEL ❑SOLID WASTE FACILITYIVEHICLE <br /> ©OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑FOOD FACILITY <br /> Q UNDERGROUND TANK(MONITORING/REMOVAL) ®WASTE TIRE ❑DAIRY,POOLISPA <br /> ®ABOVEGROUND TANK ❑CHICKEN RANCHI DOG KENNEL Q WASTEWATER TREATMENT PLANT <br /> Q HAZARDOUS WASTE ❑MEDICAL WASTE FACILITY ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> Q HAZARDOUS MATERIALS ❑TATToOIBODY PIERCING ©LAND USE APPLICATION SITES <br /> TIERED PERMITTED FACILITY 0 COMPLAINT/RESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-maB 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 it 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. <br /> ***BOXED AREA-EHD USE ONLY*** <br /> -3-11 — (-Al ca* ew 04- r &t,k r."w G— <br /> r-1 0.-n,A;9r a-'A- l b f'"afi_DDD r .Mese Staff Name: <br /> Received Time_SeP. 6. -2011_ 5: 15P4K. 2234 <br />