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a2 SAN�IOAQUIrEDEIVED <br /> _ Environmental Health Department <br /> _�Z. COUNTY--- NOV 0 3 2017 Q,tAF PUBLIC RECORDS RELEASE APPLICATION <br /> \\c9c P Greatness grows herqMp NfjWAL 87481 <br /> PEIRMIT/5EfiltflrE9 EHD LOG NUMBER: <br /> APPLICANT: LYNN KINDER BUSINESS/AGENCY: <br /> ADDRESS: 1725 DAVIS LN CITY/STATE/ZIP: RENO, NV 89511 <br /> PHONE (1): 775-240-9201 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 /> SIGNATURE OF APPLICANT PROCESSED VIA PHONE BY STAFF. DOM M DATE NOVEMBER 3,2017 <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(cDsicehd 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. I' <br /> Future file reviews by the same applicant may require a $152 deposit prior to review. JI <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List ❑ 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 /> ® Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) <br /> ® Other Cleanup Site(Non-LOP) 1010 INDUSTRIAL DR STOCKTON ®CONSUMER <br /> Hazardous Waste <br /> ►�l� <br /> ®DAIRY <br /> ®Tiered Permittetl Facility 2 <br /> ®Aboveground Tank <br /> ®UST (Monitoring/Removal) PWS <br /> ®Hazardous Materials a <br /> ® Spill/Release Response <br /> ^ ®WATER QUALITY <br /> ®Solid Wasle Facility/Vehicle 4 � L G <br /> ®Food Facility illlr <br /> ® Pool/Spa ��JJ 0 SITE MmGUMON <br /> ®Dalry s <br /> ® Land Use Application Sites <br /> ®Septic Pumper Truck/ 6 ®HousinG <br /> Yard/Chemical Toilets <br /> ®Wastewater Treatment Plant ®CUPA <br /> ®Housing Abatement T AST/HM/HW <br /> ® Motel/Hotel <br /> ®Chicken Ranch/Dog Kennel ®CUPA <br /> 8 <br /> ®Medical Waste Facility UST <br /> ®Tattoo/Body Piercing <br /> ®Waste Tire y 0 SOLID WASTE <br /> ®Complaint <br /> ® Other(Please Specify): 10 ACCOUNTING <br /> SEPTIC S WELL PERMITS,OUTSMOING FEES 10 <br /> -BOXED AREA-EHD USE ONLY*** <br /> ❑ Records provided by Staff-PPR Complete. staff Name: EHD 46-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />