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RECEIVED <br />SAN J O AQ U I N JUN o f 2018 Environmental Health Department <br />• " I .I I Y ENVIRONMENTAL HFALTH PUBLIC RECORDS RELEASE APPLICATION <br />PERMIT/SER 06g 4 r ; <br />S IT BY EMAIL <br />EHD LOG NUMBER: <br />APPLICANT: Justin Lauer BUSINESS/AGENCY: Trileaf environmental <br />ADDRESS: 2121 West chandler Boulevard Kion CITY/STATE/ZIP: Chandler. A2 85224 <br />• <br />• <br />PHONE (1): 480-850-0575 PHONE (2): FAX OR E-MAIL: i barer@lnl ccrwc <br />Please allow 10 business days from date of application submittal for the records to be available. <br />Staff will contact y u to orlon an appointment date and time to review the requested records. <br />SIGNATURE OF APPLICANT DATE 5,,,,�rY,, Z O/ Y <br />1. List up to ten addresses int the space below. Address ranges WILL NOT be accepted. Select the types) 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 infoCadsicehd.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 $162 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: <br />Specific Date Range of Information Requested: From 0vov1900 to 06107/2018 <br />ENVIRONMENTAL <br />FILE ADDRESS <br />HEALTH DEPARTMENT <br />FILES <br />Staff -PPR Complete. Starr Name: EHD dA.na <br />(Specific addresses <br />y <br />only,address ranges will not <br />be accepted) <br />p <br />EHD USE ONLY <br />ZX Underground Tank (US <br />Street <br />Street Name <br />City <br />r <br />2050 <br />Fremont St. <br />Stockton <br />CONSUMER <br />-1,0F <br />Cleanup Site (LOP) V/lj <br />IXJ Other Cleanup Site (Nan -LOP) <br />RX Hazardous Waste <br />p Dnlav <br />Q Tiered Permitted Facility <br />2 <br />Q Aboveground Tank <br />I -t NG/ lgbl Lb <br />❑ PWS <br />7/X UST (Monitoring / Removal) <br />Q Hazardous Materials <br />�X Spill Release Response <br />�X Solid Waste Facility/Vehicle <br />4neuunY <br />4' v <br />F-1Food Facility <br />WI li, t /%n �1 rl -S E M171 I10N <br />j�� �/T �/ <br />M Pool / Spa <br />Dairy <br />5 <br />W T1 <br />Land Use Application Sites <br />6 <br />❑ Houswc <br />QX Septic Pumper Truck / <br />Yard / Chemical Toilets <br />O Wastewater Treatment Plant <br />52CUPA <br />❑ Housing Abatement <br />7 <br />AST IHM I HW <br />Motel/Hotel <br />CUPA <br />Chicken Ranch I Cap Kennel <br />Medical Waste Facility <br />S <br />UST <br />Tattoo/Botly Piercing <br />®Soup WASTE <br />El Waste Tire <br />e <br />I� Complaint <br />❑ AcrouNrl"a <br />Other (Please Specify): <br />10 <br />—BOXED AREA - EMD USE ONLY... <br />1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1. www.sjcehd.com <br />❑ Records provided by <br />Staff -PPR Complete. Starr Name: EHD dA.na <br />1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1. www.sjcehd.com <br />