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RECEIVED <br /> ` <br /> nv. <br /> roKmer_ ^ HeaU*h Department <br /> –WA ' JA�� u1 -- ~C{ LJNTY <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> hcr- ENVIRONMENTAL HEALTH <br /> Greatness groIvs <br /> PERMIRSERV1,13ES EHD LOG NUMBER: 97q07 <br /> APPLICANT: In(sev\ BUSINESS/AGENCY: F_" 6— <br /> Please allow 10 business days from date of application submittal for the records to be available. Vn--t I"III, <br /> Staff will contact you to arran ap . ment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT DATE <br /> 1. List up to ten addresses in the space 66%_w. 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(cDsicehd.com. Applications received after 3:00 pm will be processed the next <br /> business day. <br /> 3. 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. Aoappointment for review will beconfirmed approximately ten (10) <br /> days after receipt ofapplication. The files will beheld for omaximum offive business days for review. Appointments <br /> should bmscheduled 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 U:O0AM-S:0OPM(EXCLUDING HOLIDAYS) <br /> Electronic information: El List D Map–Description: <br /> Specific Date Range of Information Requested: From , AJ-L to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES (Specific addresses only,address ranges will not be accepted) EHD USE ONLY <br /> Zu'nderground Tank(UST) Street# Street Name City <br /> E/Cl anup Site(LOP) CONSUMER <br /> Oth Cleanup Site(Non-LOP) C D ( I <br /> VZclous Waste o(Om 'P2" <br /> DAIRY <br /> �TclPermitted Facility <br /> Ile <br /> Aboveground Tank <br /> PWS <br /> Eg,11S`,T (Monitoring/Removal) <br /> S '111 Release Response <br /> jg�VATER QUALITY <br /> 1771 Solid Waste Facility/Vehicle 4 <br /> F]Food Facility <br /> F]Dairy 5 <br /> E]Land Use Application Sites HOUSING <br /> F-1 septic Pumper Truck/ 6 <br /> Yard I Chemical Toilets <br /> Wastewater Treatment Plant Q<0PA <br /> Housing Abatement 7 AST/HM I HW <br /> F]Motel/Hotel <br /> r-1 Chicken Ranch/Dog Kennel 5]"CUPA <br /> UST <br /> F-1 Medical Waste Facility <br /> F]Tattoo/Body Piercing SOLID WASTE <br /> n Waste Tire <br /> FJ complaint <br /> F-1 Other(Please Specify): E]AccoUNTING <br /> 0 Records provided by Staff-PPR Complete. Staff Name: EHD 48-06 <br /> 18G8E. Hazelton Avenue I Stockton, California Q5205T 208468-34201 F 200464-0138 1 vmwvv.sjoehd.uom <br />