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DECEIVED <br /> SAN J 0 A 0 U I N JUN 0 r 2038 Environmental Health Department <br /> • Y; r_TI. I I'! T Y ENVIRONMENTALHFiiii PUBLIC RECORDS RELEASEAPPLICATION <br /> PERMIT/SER <br /> IT BY EMAIL <br /> EHD LOG NUMBER: <br /> APPLICANT: Justin Bauer BUSINESS/AGENCY:Trileaf Environmental <br /> ADDRESS: 2121 West Chandler Boulevard#108 CITY/STATEIZIP:Chandler,Az 85224 <br /> PHONE(1): 480-850-0575 PHONE(2): FAX OR E-MAIL: i,bauer@mleaccom <br /> Please allow 10 business days from date of appilication submittal for the records to be available. <br /> Staff will contact y u to arl an appointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT / may DATE Z rop/T <br /> 1. List DO to ten addresses in the space below. Address ranges WILL NOT be accepted. Select the typeles fm 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 infoOsicehd.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. j`/I` <br /> Future file reviews by the same applicant may require a$152 deposit prior to review. li t5 <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> Electronic Information: p List Z Map—Description: <br /> Specific Date Range of Information Requested: From ovoln9oo to 06/0712o1e <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT y p <br /> FILES (Specific addresses only.address ranges will not be accepted) EHD USE ONLY <br /> IXJ Underground Tank(Us Street# Street Name City <br /> Cleanup Site(LOP)✓ ` ❑CONSVMER <br /> • Q Other Cleanup Site(Non-LOP) <br /> 2050 Fremont St. Stockton V0 P <br /> FXZ] Waste El pnlav <br /> ❑X Tiered Permitted Facility 2 <br /> ❑X Aboveground Tank <br /> nX UST (Monitoring/Removal) O PWS <br /> Q Hazardous Materials 3 <br /> X❑Spill Release Response <br /> 0unurr <br /> Q Solid Waste Facility I Vehicle 4 111 lq l0' I a <br /> ❑Food Facility �Y v <br /> ❑Pool/Sp. tNI Ul. r A� /�'I p` *a MITIGATION <br /> Dairy 5 i11 IN Tr VS <br /> ❑Land Use Application Siles <br /> iXJ Septic Pumper Truck/ HouswG <br /> 8 <br /> Yard/Chemical Toilets <br /> nX Wastewater Treatment Plant CUPA <br /> ❑Housing Abatement 7 AST/HM/HW <br /> ❑MatellHctel <br /> n Chicken Ranch/Dog Kennel CUPA <br /> Fl Medical Waste Facility e UST <br /> Tattoo/Body Piercing sauo WAsrs <br /> Waste Tire 9 <br /> LX7 Complaint�/ <br /> Other(Please Specify): ❑AccOUNnNG <br /> 10 <br /> -*BOXED AREA-EHD USE ONLY"" <br /> L'7-1 -'MbIl n Can :,rh ei /2 a0Y � p/a :4",4 <br /> 1 <br /> • <br /> ❑ Records provided by Staff-PPR Complete. staff Name: EHID 40.0E <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />