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RECEIVED <br /> r' SAN :J O A Q U I N Environmental Health Department <br /> -COUNTY— JAN 1-* 2018 PUPLICRECORDS RELEASE <br /> APPLICATION <br /> 2) <br /> Gr,=otness rotes lter d NMI NRA t� VIV+4 <br /> Y[�Folt' 9 �Pfl/IRANIdEItC�ALh .T'1�1 k-)'- <br /> PERMfT/S8 EHD LOG NUMBER: <br /> APPLICANT: Wendy Bellah BUSINESSIAGENCY: Terraphase Engineering <br /> ADDRESS: 1404 Franklin Street,Suite 600 CITYISTATE/ZIP: Oakland, <br /> PHONE(1): 510-645-1850 X83 PHONE(2): 415-314-0368 FAX OR E-MAIL: wendy.bellah(a)terraDhase.com <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will cont ra a an a of nt ate and time to review the requeste4 records. <br /> SIGNATURE OF APPLICANT � DATE �- J <br /> 1. List up to ten addresses lhthd space beIQ3W. Ad ress ranges WILL NOT be accepted. Select the type( )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 infoRsicehd.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, t <br /> Future file reviews by the same applicant may require a$152 deposit prior to review. I -1 <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From 1900 to Curren <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT (Specific y 9 p ) EHD USE ONLY <br /> FILES S ecific addresses crit atldress ran es will not be acre ted <br /> ®Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) CONSUMER t 757 East 11th St. Tracy <br /> Other Cleanup Site(Non-LOP) 1Z P <br /> ®Hazardous Waste ' 1t,/, 4+m P �'���" /L0 Dune <br /> ❑Tiered round Ta Facility 2 2401 N.MacArthur Drive TracypFt r"•."tp'V' Cr,(tL 1' 14W &e4— A✓gr <br /> ®Aboveground Tank <br /> ❑UST (Monitoring/Removal) /f ! 0 PWS <br /> �J <br /> XQ Hazardous Materials <br /> Spill/Release Response <br /> gw�nr <br /> F1 solid Waste Facility 1 Vehicle i Arsn <br /> ❑Food Facility <br /> F1 Pool/Spafismi MmwnoN <br /> '"7 <br /> F1 Dalry a r f s7 <br /> ❑Land Use Application Sites <br /> 13 HausiNo <br /> Sepik Pumper Truck/ <br /> Yard I Chemical Toilets <br /> Wastewater Treatment Plant q CUPA <br /> F1 Housing Abatement T W ASTIHMIHW <br /> n Motel/Hotel <br /> ❑Chicken Ranch/Dog Kennel /' ❑CUPA <br /> a / UST <br /> ❑Medical Waste Facility <br /> ❑Tattoo/Body Piercing p SOUR WASTE <br /> ❑Waste Tire g <br /> ❑Complaint <br /> ❑Other(Please Specify): ❑Accoutrtma <br /> 1a <br /> •"•BOXED AREA-EHD USE ONLY'•• <br /> • 1 I(a l$-f tlApo <br /> i9t :r ,e e lore <br /> ❑ Records provided by Staff-PPR Complete.staff Name: Deo nnue <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-34201 F 209 464-0138 1 www.sjcehd.com <br />