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RECEIVE' <br /> SAN J OAQ U I N 2017 Environmental Health Department <br /> --COU NTY------ PUBLIC RECORDS RELEASE APPLICATION <br /> Grrutness yrorv• !;Fr; NENTA.L } 1`t <br /> 1EM►+llMER11GES EHD LOG NUMBER: 7 1 <br /> APPLICANT: Karin Hagan BUSINESSIAGENCY: K einfelder <br /> ADDRESS: 2280 Market Street, Suite 300 CITYISTATE/ZIP: Riverside, CA 92501 <br /> PHONE (1): 703-509-5941 PHONE(2): FAX OR E-MAIL: khagan -kleinfelder.com <br /> Please allow 10 busi ess days f om date of application submittal for the records to be available. <br /> Staff will contact ou to err a an appointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT DATE 1112117 <br /> 1. List up to ten addresses in ace: 1 . Address ranges WILL NOT be accepted. Select the types) of files from the <br /> list below by checking the propriate b x(es). At least one file type MUST be selected. Fax to(209)464-0138, mail to the <br /> address indicated below, email to info s'cehd.-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: X❑ List © Map —Description: Any <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT (Specific addresses andY address ranges will not be accepted) EHD USE ONLYFILES <br /> ®Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) 0 CONSUMER <br /> Other Cleanup Site(Non-LOP c' 3028 Navy Drive Stockton ;y, / <br /> ®Hazardous Waste I j} �I DAIRY <br /> ®Tiered Permitted Fatality 2 !�f, <br /> 1 / L <br /> ® <br /> Aboveground Tank <br /> ®UST (Monstorin9 1 Removal) ❑PWS <br /> ® 3 �- (4 <br /> Hazardous Materials <br /> ®Spill d Release Response WAraR Cunuty <br /> Solid Waste Facility!Vehicle 4 <br /> Food Facility — <br /> Pool J Spa J`ITEM 1VGATION <br /> Q Dalry 5 �� I ` e i/ <br /> ®Land Use Application Sites HOUSING <br /> ®Septic Pumper Truck! a / ❑ <br /> Yard I chemical Toilets 7 <br /> ® <br /> wastewater Treatment Plant L-0 <br /> `t ifLHousing Abatement 7 0Com/ AST1HM1HW <br /> Motel/Hotel lll��� 111 <br /> CU <br /> Chicken Ranch!Dog Kennel PA <br /> a (� UST <br /> Medical Waste Facility <br /> ❑TattoolBody Piercing - t, aL.WASTe <br /> Waste Tire g <br /> ®Complaint <br /> F1 Other(Please Specify): ❑AcceUNnNG <br /> 10 <br /> ***BOXED AREA-EHD USE ONLY <br /> � — 0 00q5q <br /> ❑ Records provided by Staff-PPR Complete. staff Name., EHD 48-06. <br /> 1868 E. Hazelton Avenue I (Stockton, California 95205 1 +T,\2)09 468-3,x420 1 IF 209 464-0138 1 sjcehd.com I /_ <br />