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®® 10 2018 11:57AM Company 5593745 1 1 <br />RECEIVED <br />:o: SAWJOAQUIN <br />® JUL '10, Z018 Environmental Health Department <br />COUNTY -' PLI RECORDS RELEASE APPLICATION <br />• - G/�rtnr�yc arrs:r5 hr~,J1/IR(?NMfr - Q� <br />PERMIT/Si BY F.MAIL _ '10 cli 0 <br />EHD LOG NUMBER. <br />APPLICANT: Paul Humphrey BUSINESS/AGENCY: <br />ADDRESS: 7402 E. Clinton Ave CITY(STATE/ZIP: Fresno, CA 93737 <br />PHONE (1): 559 977-9813 PHONE (2): FAX OR E-MAIL: paul@esahumphrey <br />Please allow 10 business days from date of application submittal for the records to be available. <br />Staff will contact yo arrange an poi ent date and time to review the requested records. <br />SIGNATURE OF APPLICANT �r DATE July 10, 2018 <br />1. List up to ten addresses in the space below. Add ss rang ILL 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 infApplications 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. y(� <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 6:00 AM-5:00PM (EXCLUDING HOLIDAYS) <br />- Electronic Information: ❑ List ❑ Map — Description: <br />Specific Date Range of Information Requested: From ,ty <br />4 <br />fn <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />FILE ADDRESS <br />� C 1J 13 ( F , <br />FILES <br />(Specific addresses <br />only, address ranges will not <br />be accepted) <br />EHD USE ONW_ <br />7X underground Tank (UST) <br />Street # <br />Street Name <br />City <br />Cleanup Site (LOP) <br />Other Cleanup Site (Non -LOP) <br />t <br />tq'rJ <br />, L �O <br />, -�,IFTWir A <br />�^� C <br />1 <br />CONSUMER <br />� <br />QX Hazardous waste <br />� <br />•�. <br />2 <br />/1Z + <br />(�•/ �V•/ <br />Pa i/��6yt e46, <br />1 V <br />.�+r1` <br />` <br />i oalRr <br />QX Tiered Permitted Facility v <br />0 Aboveground rank <br />J 1 <br />�V�v ; 6 CT 14M1 R' <br />QX UST (Monitoring /Removal) <br />El PWS <br />0 Hazardous Materials <br />s <br />I� Spill ! Release Response <br />© WATER QUALITY <br />0 Solid Waste Facillty / Vehicle4 <br />Food Facility <br />Pool / Spa <br />� SITE MITIGATION <br />Dairy <br />5 <br />FX Land Use Application Sites <br />8 <br />HOUSING <br />�] Septic Pumper Truck/ <br />Yard / Chemical Toilets <br />❑ Wastewater Treatment Plant <br />❑ Housing Abatement <br />7 <br />Q'CUPAAST/ <br />Motel/Hotel <br />HM / HW <br />Chicken Ranch / Dog Kennel <br />Q COPA <br />Medical Waste Facility <br />8 <br />UST <br />Tattoo/Body Piercing <br />9 <br />F Souo WASTE <br />❑ Waste Tire <br />❑ Complaint <br />El Other (Please Specify): <br />10 <br />+ 0^V=M <br />(] AccoUNnNG <br />- <br />wnw much - CIIN UAC UNLT' <br />❑ Records provided by Staff -PPR Complete. staPlNam®: <br />EH <br />Re c e i v d T i 1nem,l a 1. 10. j12013:o11 ; 50061No, 3847205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />