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RECEIVED <br /> SANsJOAQUIN710 dad Environmental Health Department <br /> � 30--COU NTY-- PUBLIC RECORDS RELEASE APPLICATION <br /> -� � (:'i.CCnr.S; �fO N'S FIPrFN1/1RQNAut ���' <br /> • PEI!{41fTlS AIL <br /> EHD LOG NUMBER: <br /> APPLICANT: Reena Raisin(Broker)r Gurmeet[)ebb(Buyer) BUSINESSIAGENCY:Quick!Kleen Car Wash <br /> ADDRESS: 707 E Yosemeti Ave CITY/STATE/ZIP:Manteca <br /> PHONE(1): (415)866-3440 PHONE(2):(510)846-2194 FAX OR E-MAIL: rPaleja@gmail.com <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 /> SIGNATURE OF APPLICANT a� DATE 05130/201e <br /> 1. List up to ten addresses in the space below. Address ranges WILL NOT be accepted. Select the type(s)of files from the <br /> list below by checking the appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138, mail to the <br /> address indicated below,or email to info(dsicehd.com. Applications received after 3:00 pm will be processed the next <br /> business day. <br /> 2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted below. <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$152 deposit prior to review. ()l/ <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM•5:00PM(EXCLUDING HOLIDAYS) <br /> Electronic Information: XQ List x❑ Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT <br /> FILES (Specific addresses only,address ranges will not be accepted) EHD USE ONLY <br /> XX Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) 707 <br /> XX Other Cleanup Site(Non-LOP) 1 707 E Yosemite Ave Manteca <br /> X_l Hazardous Waste D DAIRY <br /> R Tiered Permitted Facility 2 1 , , <br /> Z Aboveground Tank H �V_ J\ SI"�. W <br /> RX UST (Monitoring/Removal) ❑PWS <br /> 1 <br /> Q Hazardous Materials <br /> RX Spill I Release Response 1 <br /> UII, V� ATER QUALITY <br /> Solid Waste Facility/Vehicle 4 CIO Z Food Facility (� <br /> Ej Pool I Spa Sre MincnnoN <br /> Dairy 8 <br /> Land Use Application Sites <br /> HOU61 G <br /> Septic Pumper Truck/ 9 <br /> Yard/Chemical Toilets <br /> E]Wastewater Treatment Plant [gCUPA <br /> Housing Abatement 7 ASTI HM I HW <br /> Motel/Hotel <br /> Chicken Ranch/Dog Kennel CUPA <br /> 8 UST <br /> Medical Waste Facility <br /> TBUDO/Body Piercing p SOLID WASTE <br /> Waste Tire 9 <br /> Complaint <br /> Other(Please Specify): ❑AOCOUMING <br /> iG <br /> —BOXED AREA-EHD USE ONLY— <br /> ❑ Records provided by Staff-PPR Complete. staff Name: EHD M oa <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />