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. �� �=�� � <br /> SAN <br /> J �,� � 1 � ����� ��� � �� �_U4^ronmen . ��eafth Department <br /> ---COUNTY--- pUBL|(� RECURD3RELEASE APPL|CAT|{}N <br /> �8� 0 � ���� <br /> EWRONWKEAL HEIRALTH IEHD LOG NUMBER: 89271 <br /> APPLICANT: Betsy Hosko BUSINESS/AGENCY: GHD <br /> , '`�° v � +�vv <br /> ADDRESS: 20Gothic Ct, Ste 109 CITY/STATE/ZIP: Franklin,TN 37067 <br /> PHONE (1): 615-721-0669 PHONE(2): 734'5524221 — FAX OR E-MAIL: betsy.hosko@qhd.coin <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 DFAPPLICANT Processed vii| by Staff. Dom M DATE 8/2/2018 <br /> 1. List up to ten addresses inthe space below. Address ranges WILL NOT beaccepted. Select the typo(a)offiles from the <br /> list below bychecking the appropriate bnx(oo). Atleast one file type MUST boselected. Fax to(209)464-0138, mail to the <br /> address indicated below, or email to infogsicehd.com. Applications received after 3:O0pmwill baprocessed 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 EHDwill notify the applicant ifany EHDfiles exist. Anappointment for review | (10) <br /> days after muoiptofapp!ioaUon. The�|oswill boheld for omaximum of�vobuoin s rt4R�&intmonto <br /> should boscheduled accordingly. <br /> NF 00' N� '�� <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 bythe same applicant may require u $152deposit prior toveviaw <br /> � <br /> SEPTIC AND WELL PERMITS ARE AVAILABLE FOR REVIEW ONLINE AT: httpc0wvmw.sjgov.orgldopurtmonVonvhooltNpub|io'm000ds <br /> onic Information: E] List [] Map— Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES (Specific addresses only, address ranges will not be accepted) EHD USE ONLY <br /> 0 Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP E]CONSUMER <br /> Z Other Cleanup Site(Non-LOP) 1 2321 W Washington St StocktonZ Hazardous West DI' <br /> —BOXEDZ Tiered Permitted Fad% 2 HM, HW,WT,COMP <br /> Z Aboveground Tan <br /> Z UST (Monitoring I Removal) PWS <br /> Z Hazardous Material <br /> Z Spill I Release Response Z WATER QUALITY <br /> Food Facilit <br /> Pool/Spa SITE MITIGATION <br /> 24ky —5 <br /> E]Land Use Application Sites <br /> Z Septic Pumper Truck 1 6 Ej HOUSING <br /> Yard/Chemical Toilets <br /> Medical Waste Eadlity 8 UST <br /> Tattoo/Body Piercing Z SOLID WASTE <br /> Z Complain <br /> Septic&Well Permits 10 <br />