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C <br />• <br />RECEIVED <br />SAN ) OA Q U IN t4k 3 0 2LliEnvironmental Health Department <br />C 0 U N1 T Y--- PUBLIC RECORDS RELEASE APPLICATION <br />EWRONWNTAL HEALTH/J <br />Grctatit ss rows 3i�r: iMI -'VC <br />REi'I <br />AIL l� <br />!6 �)02W <br />A EHD LOG NUMBER: <br />APPLICANT: Lyna Black BUSINESS/AGENCY: Jacobs <br />ADDRESS: 2525 Air Park Drive CITYISTATE/ZIP: Redding, CA 96001 <br />PHONE (1): 530-229-3295 PHONE (2):530-680-5276 FAX OR E-MAIL: lyna black@jacobs.com <br />Please allow 10 business days from date of application submittal for the records to be available. <br />Staff will contac you to r e an appointment date and time to review the requested records. <br />SIGNATURE OF APPLICANT r, Y DATE ;� �;o P�, <br />1. List un to ten addresses In the 4pac6 below. Address ranges WILL NOT be accepted. Select the typ (s) of files from the <br />list below by checking the appropriate box(es). At least one file type MUST be selected. Fax to (2091464-0138, mail to the <br />address indicated below, or email to lnfo@sicehd.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 END staff at the expense of the applicant. <br />Future file reviews by the same applicant may require a $152 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 >,r +�--..T S 't ter' i to .. r-rr—L <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />FILES <br />(Specific addresses <br />FILE ADDRESS <br />only, address ranges will <br />not be accepted) <br />A..C? 0 tp f 2q my 57, <br />EHD USE ONLY <br />Underground Tank (UST) <br />Street # <br />Street Name <br />city <br />Cleanup Site (LOP) <br />Other Cleanup Site (Non -LOP) <br />Hazardous Waste <br />Tiered Permitted Facility 2 <br />j Aboveground Tank <br />UST (Monitoring l Removal) <br />tB Hazardous Maledals 3 <br />®:Spill/Release Response <br />cON5U4EP <br />to :•7 <br />J ! I'� f:7y C t (Z <br />-. <br />*IF <br />p, <br />� <br />O. <br />203 <br />TCrl S <br />r, Pws <br />' <br />ND i)B <br />-✓1,Y <br />"OATFIR GUAI rrY <br />aD S <br />Solid Waste Facility! Vehic:q <br />Food FacilityL4 <br />Pool 1 Spa <br />Dairy b <br />Land Use Application SiNs <br />c� CN <br />b' ITB M;Tr..AT70N <br />�lj ' <br />S- �t i �,, <br />{t <br />HousiNa <br />m ttvv, <br />I l i i t Y U V <br />Sepllc Pumper Truck ! R <br />Yard /Chemical Toilets 0 <br />�] Wastewater Treatment Plant <br />Housing Abatement 7 <br />C] MoleUHoiei <br />71 ZALij 'V1V I�1 <br />✓ <br />\jrL tL <br />tiiM �) GUPA <br />ASTlHM1HW <br />/�... P1 <br />Ir 141L0�( <br />®'COPA <br />UST <br />I <br />Chicken Ranch! Dog Ksnnel <br />E <br />Medical Waste Faculty <br />Tattoolaody Piercing <br />[] Waste Tire g <br />Complaint <br />SOLID WASTE <br />Other (Please Specify) <br />to <br />I <br />❑ Accowmwi <br />avncr.r rane.v - enu tag j!a <br />IV, JU2 'C ~ ` ir2 A� V <br />C00012 Ifl 271 1= a <br />D Records provided by Staff -PPR Complete. staff Name: Lk�-ri LCD EHD4s-os <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />