Laserfiche WebLink
:■: 22 2018 03:44PM Company 5593745711 page 1 <br />ON RECEIVED ED <br />NINE <br />.� SAN JOAQUINe 2018 PUB <br />Health Department <br />COUNTY PLIC RECORDS RELEASE APPLICATION <br />ENVIRON <br />PERMl0 EHD LOG NUMBER: <br />APPLICANT: Paul Humphrey BUSINESS/AGENCY: <br />ADDRESS: 7402 East Clinton Ave. <br />CITY/STATE/iFresno, CA 93737 <br />PHONE (1): 559-977-9813 PHONE (2): FAX OR E-MAIL: paul@esahumphrey,com <br />Please allow 10 business days from date of application submittal for the records to be available. <br />Staff will con7x—,# <br />to arran an ap - tment date and time to review the requested records. <br />SIGNATURE OF APPLICANT DATE June 22.2018 <br />1. List up to ten addresses In the space below. Kddress rafiges WILL NOT be accepted. Select the types) 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 infogDsicehd 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 behold 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. 3 <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:00PM (EXCLUDING HOLIDAYS) <br />Electronic Information: El List ❑ Map — Description: <br />Specific Date Range of Information Requested: From to <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />FILES <br />(Specific addresses <br />FILE ADDRESS <br />only, address ranges will not <br />be accepted) <br />�–� Lel Z IF <br />EHD USE ONLY <br />QX Underground Tank (UST) <br />Street # <br />Street Name <br />City <br />1718 <br />Boeing Way <br />Stockton <br />. ❑CONSUMER <br />t <br />Cleanup Site (LOP) <br />Other Cleanup Site (Non -LO <br />,4J Hazardous Waste <br />l� Tiered Permitted Facility <br />❑X Aboveground Tank <br />2 <br />�I <br />DAIRY <br />PWS <br />❑X UST (Monitcring / Removal) <br />1ZHazardous Materials <br />J <br />FX Spill I Release Response <br />' <br />q <br />'WATER QUALI-TY <br />❑X Solid Waste Facility / Vehicle <br />❑ Food Facility <br />❑ Pool I Spa <br />❑• SITE MlTrcanoW <br />❑ Dairy <br />5 <br />❑X Land Use Application Sites <br />B <br />❑ HOUSING <br />Septic Pumper Truck / <br />Yard / Chemical Toilets <br />❑ Wastewater Treeitmenl Plant <br />❑ Housing Abatement <br />CUPA <br />AST/HM/HW <br />7 <br />❑ Motel/Hotel <br />e <br />Q COPA <br />usT <br />❑ Chicken Ranch / Dog Kennel <br />❑ Medical Waste Facility <br />Tattoo/Body Piercing <br />F-1WasteTire <br />F] Complaint <br />9 <br />Q SOLID WASTE <br />F1 Other (Please Specify): <br />1e <br />❑ ACOOUNnNG <br />—BOXED AREA - EHD USE ONLY '" <br />25-1', - C,Ae,� Ism ( ..,k 11 <br />10, <br />El Re ords provide by Staff -PPR Complete. staffNani EHD49-M <br />1A(t,a F= wn7lton o„or,l.o I c��cl f--lif,,..,,., `05 1 T 209 468-3420 I F 209 464-0138 1 www.sjcehd.com <br />Rerelve(1 Tirl)e Jun.22.r2018 �.37PM No. 3761 <br />