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SAN AN JOAQU <br />'WL 1 2018 Environmental Health Department <br />U N TY— PUBLI RECORDS RELEASE APPLICATION <br />• !> eotr.css yrcvrs hecNVIRONMENT /V��1G <br />G <br />M)6PERMITISE <br />EHD LOG NUMBER: <br />• <br />• <br />APPLICANT: dames Plesec <br />ADDRESS: 18703 Shawnee Avenue <br />BUSINESSIAGENCY: CBP.E <br />CITYISTATEIZIP: Cleveland/Ohio/44119 <br />PHONE (1): PHONE (2): FAX OR E-MAIL: james.plesec@cbre corn <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 PA.. DATE duly 16, 2018 <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 1209) 464.0138, mail to the <br />address indicated below, or email to infoOsicehd.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. 2 <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: restaurants <br />Specific Date Range of Information Requested: From ov01/1999 to F; 16%2018 <br />ENVIRONMENTAL <br />FILE ADDRESS <br />'--Gp i l I} lg P. <br />HEALTH DEPARTMENT <br />FILES <br />S eci5c addresses address ranges will not be accepted) <br />(ponly, 9 p <br />EHD USE ONL <br />I� Underground Tank (UST) <br />Street # <br />Street Name <br />city <br />Cleanup Site (LOP) <br />1 <br />3060 <br />Naglee <br />Tracy <br />W_%, noq y CO jp p CONSUMER <br />--02 <br />�X Other Cleanup Site (Non -LOP) <br />I Fine <br />Q Hazardous Waste <br />i1YMADAim <br />��`�� CC) IT <br />Q Tiered Permitted Facility <br />2 <br />3080 <br />Naglee <br />Tracy <br />Q Aboveground Tank <br />r111 r — <br />Z UST (Monitoring / Remova <br />O Hazardous Materials <br />3140 <br />Naglee <br />Tracy <br />NMl <br />HDCV p - CD(5P ❑ PWS <br />ft�be^cv2 <br />❑X Spill /Release Response <br />ATERDOALTY <br />Q Solid Waste Facility /Vehicle <br />q <br />❑ Food Facility <br />SITE MRIGATION <br />n Pool / Spa <br />❑ Dairy <br />a <br />E] Land Use Application Sites <br />a <br />❑ HOUSING <br />F1 Septic Pumper Truck / <br />Yard I Chemical Toilets <br />El Wastewater Treatment Plant <br />215,up, <br />E] Housing Abatement <br />7 <br />AST I HM I HW <br />F1 MotelMotel <br />OFn <br />❑ Chicken Ranch / Dog Kennel <br />Q Medical Waste Facility <br />a <br />UST <br />Talloo/Body Piercing <br />Sou. WASTE <br />Q Waste Tire <br />g <br />Complaint <br />❑ AccourrTios <br />E] Other (Please Specify): <br />10 <br />—BOXED AREA - EHD USE ONLY"` <br />7-� -Itis C�.tt�5 o,) -VntkrnLe" , r <br />1 <br />❑ Records provided by Staff -PPR Complete. staff Name: EHD 48-06 <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />