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SAN JDAHIN <br />COUNTY_ <br />kirecitriess grows he:: <br />APPLICANT: Raul Gaina <br />Environmental Health Department <br />PUBLIC RECORDS RELEASE APPLICATION <br />SUBMIT BY EMAIL <br />EHD LOG NUMBER: <br />BUSINESS/AGENCY: EFI Global <br />ADDRESS: 5261 W. Imperial Hwy CITY/STATE/ZIP: Stockton, CA 95203 <br />PHONE (1): 310-854-9300 PHONE (2): FAX OR E-MAIL: Raul.Gaina@efiglobal.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 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 infoasicehd.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. <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 to <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />FILES <br />(Specific addresses <br />(p <br />FILE ADDRESS <br />only, address ranges will not <br />y g <br />be acce ted <br />accepted) <br />��lo C <br />EHD USE O Y <br />Q Underground Tank (UST) <br />Street # <br />Street Name <br />City <br />1 <br />705 <br />Carlton Avenue <br />Stockton <br />�c T 1f11M E] CONSUMER <br />'.] ) lltt1 <br />Cleanup Site (LOP) <br />QX Other Cleanup Site (Non -LOP <br />Q Hazardous Waste <br />0 Tiered Permitted Facility <br />2 <br />C nD(�1 CO'S� ❑DAIRY <br />\ 1 <br />FYI Aboveground Tank <br />❑ PWS <br />Q UST (Monitoring I Removal) <br />Q Hazardous Materials <br />3 <br />n Spill / Release Response <br />E] Solid Waste Facility / Vehicle <br />4 <br />E) WATER QUALITY <br />F] Food Facility <br />❑ SITE MITIGATION <br />Pool / Spa <br />Dairy <br />5 <br />F] Land Use Application Sites <br />Septic Pumper Truck / <br />Yard / Chemical Toilets <br />6 <br />1:1HOUSING <br />Wastewater Treatment Plant <br />VCUPA <br />Housing Abatement <br />7 <br />AST/HM I HW <br />Motel/Hotel <br />❑ CUPA <br />Chicken Ranch / Dog Kennel <br />Medical Waste Facility <br />8 <br />UST <br />Tattoo/Body Piercing <br />Waste Tire <br />9 <br />❑ SOLID WASTE <br />Complaint <br />❑ ACCOUNTING <br />Other (Please Specify): <br />10 <br />***BOXED AREA - EHD USE ONLY*** <br />Records provided by Staff -PPR Complete. Staff Name: EHD 48-06 <br />1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />