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RECEIVED <br />SAN J O A Q U 1 N Environmental Health Department <br />• C OU RI T Y--"l'PUBLIC RECORDS RELEASE APPLICATION <br />eu"ttlB i S tlt EWP.0l V �IAIL Q11 �7 <br />qLi <br />PEiV fT/5 EHD LOG NUMBER:ww <br />APPLICANT: Melanie Mariotti BUSINESS/AGENCY: Paladin Law Group, LLP <br />ADDRESS: 1176 Boulevard Way CITY/STATE/ZIP: Walnut Creek, CA 94595 <br />PHONE (1): 925-947-5700 PHONE (2): FAX OR E-MAIL: mmariotti@paladinlaw.com <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 Melanie A. Mariotti DATE <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(a)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 EHD staff at the expense of the applicant. <br />Future file reviews by the same applicant may require a $152 deposit prior to review. Zy <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 1950 to P'e:'a,t <br />ENVIRONMENTAL <br />FILE ADDRESS <br />HEALTH DEPARTMENT <br />FILES <br />(Specific addresses <br />only,address ranges will not <br />be accepted) <br />EHD USE ONLY <br />❑X Underground Tank (UST) <br />Street # <br />Street Name <br />City <br />1 <br />416 <br />W. Yosemite Ave. <br />Manteca <br />❑ CONSUMER <br />}1�,��;�.jy <br />t <br />Cleanup Site (LOP) <br />Q Other Cleanup Site (Non -LOP <br />Q Hazardous Waste <br />4 ~ ❑ DAIRY <br />❑ Tiered Permitted Facility 4 <br />2 <br />420 <br />W. Yosemite Ave. <br />Manteca <br />1IVw ���� Ae <br />Q Aboveground Tank <br />} <br />❑ PWS <br />Q UST (Monitoring / Removal) <br />Q Hazardous Materials <br />3 <br />Q Spill / Release Response <br />4 <br />ATER QUALITY <br />Solid Waste Facility / Vehicle <br />❑ Food Facility <br />ITE MITIGATION <br />❑ Pool / Spa <br />❑ Dairy <br />5 <br />� � <br />❑ Land Use Application Sites <br />t/lJL <br />C]HOUSING <br />❑ Septic Pumper Truck I6 <br />Yard / Chemical Toilets <br />Wastewater Treatment Plant <br />COPA <br />Housing Abatement <br />7 <br />AST / HM I HW <br />❑ Motel/Hotel <br />CUPA <br />0 Chicken Ranch / Dog Kennel <br />Medical Waste Facility <br />8 <br />UST <br />Tattoo/Body Piercing <br />❑ SOLID WASTE <br />E] Waste Tire <br />9 <br />Q Complaint <br />❑ AccouNTING <br />❑ Other (Please Specify): <br />10 <br />***BOXED AREA - EHD USE ONLY*** <br />4 ;-lG �1 te-aIA 0 (P" A.:'4wnA Vf Y'LkL.. "a I.,'?- �V47_1' 1 'i Ie" ✓ G,-'— 11 <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 />vno <br />tZ. <br />