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RECEIVED <br /> � SAN JQAQUI Environmental Health Department <br /> COUNTY— �'� �iif!pMpUILIC RECORDS RELEASE APPLICATION <br /> rG1 t rellin:ss i r'i��°.5 ltcr �, 18 <br /> u IS34 <br /> _WAL <br /> FEF"'MAITISERh ;E3 ' EHD LOG NUMBER: <br /> APPLICANT: Wendy Bellah BUSINESSIAGENCY: Terraphase Engineering <br /> ADDRESS: 1404 Franklin Street, Suite 600 CITYISTATEIZIP: Oakland, 4 <br /> 612 <br /> PHONE (1): 510-645-1850 X83 PHONE(2): 415-314-0368 FAX OR E-MAIL: wend Y.bell ah(cDterraphase.com <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contacran a an a of nt ate and time to review the reiqueste recti ds. <br /> SIGNATURE OF APPLICANT DATE - 1 <br /> 1. List up to ten addresses i h space bel . Ad ress ranges WILL NOT be accepted. Select the type(g)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(c-)sicehd.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. f <br /> Future file reviews by the same applicant may require a$152 deposit prior to review. � 1/ <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8,00 AM-5:OOPM (EXCLUDING HOLIDAYS) <br /> Electronic information: ❑ List❑ Map-Description: <br /> Specific Date Range of Information Requested: From 1900 to current <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT <br /> FILES (Specific addresses only,address ranges will not be accepted) EHD USE ONLY <br /> Underground Tank(UST) Street# Street Name City <br /> Cleanup Sita(LOP) t� []CONSUMER <br /> Other Cleanup Site(Nan-LOPS ' 757 East 11th St. Tracy L.PV <br /> ®Hazardous Wastef Ani 1 V '✓ <br /> II 4+hl P (+I,.,a",, rl— <br /> DAIRY <br /> Tiered Permitled Facility z 2401 N.MacArthur Drive TraCy • "t V' 17�, � r r&QM <br /> ©Aboveground Tank <br /> n lb <br /> UST (Monitoring f Removal) PWS <br /> a <br /> I�Hazardous Materials <br /> 171 Solid <br /> 1 Release Response <br /> P"WATER QUALItY <br /> Solid Waste Facility!Vehicle q <br /> Food Facility <br /> ®Pool!Spa '7 �]SrrE MIrm-noN <br /> ®Dairy 6 fc7 : <br /> ®Land Use Application Sites J <br /> F1Septic Pumper Truck I s h 1 /I� /l f]k J 0 HOUSING <br /> Yard I Chemical Toilets ft49J <br /> /f`f/ 1T� 1 <br /> ❑ <br /> Wastewater Treatment Plant. + � ! ,t CUPA <br /> Housing Abatement 7 /V[�/I � n�, r'�i`" AST1HMrNw <br /> Q Motel/Hotel <br /> ®Chicken Ranch I Dog Kennel r /' ❑CUPA <br /> e ( UST <br /> ®Medical waste Facility <br /> Taitoo)Hody Piercing SOLID WASTE <br /> waste Tire a <br /> Complaint <br /> ❑Other(Please Speciry): ©Ac�DUNr3Ne <br /> 9e <br /> —BOXED AREA-EHD USE ONLY— <br /> j-1 c� �:h. a"n �_' Ir <br /> O Records provided by Staff-PPR Complete. Staff Name: EHD 43-CS <br /> 1868 E. Hazelton Avenue 1 Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />