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RECEIVED pojd5-u('1' <br />SAN JOAQUIN��;� ��� Environmental Health Department <br />-----COUNT � <br />Y---- 6 PUBLIC RECORDS RELEASE APPLICATION <br />C1'(kil � <br />G Is <br />ENS RO EMAIL V <br />PEf9MR EHD LOG NUMBER. <br />APPLICANT: Megan Mauer <br />ADDRESS: 1221 S Congress Ave. Apt 238 <br />BUSINESS/AGENCY: eScreenLogic <br />CITY/STATE/ZIP: Austin, Tx 78704 <br />PHONE (1): 5128787055 PHONE (2): FAX OR E-MAIL: m macer@escreenlogic.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 m.mauerLescreenlogic Com - - DATE 5'31/18 <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. /t� <br />Future file reviews by the same applicant may require a $152 deposit prior to review. <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) <br />Electronic Information: X❑ List XX Map— Description:= ¢ _L , 1 r� �l i % i W, _i g_�i L �i <br />Specific Date Range of Information Requested: From <br />ENVIRONMENTAL <br />FILE ADDRESS <br />�-' CZ; 6-1q �$ <br />HEALTH DEPARTMENT <br />FILES <br />(Specific addresses <br />(p <br />only, address ranges will not <br />y 9 <br />be acce ted <br />accepted) <br />PHT'I'D" USE ONLY <br />X❑ Underground Tank (UST) <br />Street # <br />Street Name <br />City <br />Cleanup Site (LOP) <br />1 <br />UL� I J,-\ <br />V1l��IJI <br />❑ CONSUMER <br />XJ Other Cleanup Site (Non -LOP) <br />Do ot `lI, �e eQ6�. �� <br />Q Hazardous Waste <br />Tiered Permitted Facilit m '/'+ <br />il <br />U#_41//' <br />2 <br />8751 <br />Hwy 12 <br />0 I-01, t.kytiI'tU <br />{' <br />Vii <br />(. ❑DAIRY <br />�vi,��'�Q <br />L <br />Aboveground Tank <br />'t01 <br />k`�T � P <br />J <br />I�`ML OAtIN <br />❑PWS <br />Q UST (Monitoring /RemOW <br />oval) y <br />Q Hazardous Materials �P <br />31725& <br />I c O r <br />Q Spill / Release Response <br />�L <br />tg&ATER QUALITY <br />Solid Waste Facility /Vehicle <br />4 <br />� O <br />O <br />Food Facility <br />r <br />1/M <br />SITE MITIGATION <br />Pool / Spap <br />F] Dairy <br />5 <br />8 <br />- <br />Land Use Application Sites <br />El HouslNc <br />Septic Pumper Truck / <br />6 <br />p <br />U <br />_ <br />Yard / Chemical Toilets <br />Wastewater Treatment Plant <br />i( COPA <br />❑ Housing Abatement <br />--Victor_ - <br />AST / HM I HW <br />❑ Motel/Hotel <br />COPA <br />❑ Chicken Ranch / Dog Kennel <br />Medical Waste Facility <br />8 <br />wy <br />I Ctor <br />UST <br />❑ Tattoo/Body Piercing <br />LL/ L <br />E] SOLID WASTE <br />❑ Waste Tire <br />gwy <br />Complaint <br />Other (Please Specify): <br />❑ ACCOUNTING <br />17285 <br />N BF6611a <br />—BOXED AREA - EHD USE ONLY— <br />r <br />Alt. t. c u ; <br />V Y H D 48-06 <br />1-751 14" "Z. <br />1868E. Hazelton Avenue l Stockto Califor la 5205 1 T 209468-342 F 209 464- 138 I www.s cehd.co <br />R <br />