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SAN J 0 A C � CEIVEDi,,,4 Environmental Health Department <br /> —C O U Pd T r PR 18 2018 of PUBLIC RECORDS RELEASE APPLICATION <br /> r5 . ENWRONWNTALH IT BY EMAIL �3VLI�r3 <br /> Ask PERMIT/SERVICE EHD LOG NUMBER: <br /> APPLICANT: KEVIN JOHNSTON BUSINESS/AGENCY: <br /> ADDRESS: 2288 BUENA VISTA AVENUE CITY/STATE/ZIP:LIVERMORE CA 94550 <br /> PHONE(1): 9254475200 PHONE(2): FAX OR E-MAIL: CAT416CIT@GMAIL.COM <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to ar n �p ent date and time to review the requested records. <br /> SIGNATURE OF APPLICANT �� � DATE 4.13-18 <br /> 1. List up to ten addresses in th ace below dress 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 /> 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. L1/-7 <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 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List ❑ Map— Description: <br /> Specific Date Range of Information Requested: From ALL to PRESENT <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT ` Specific addresses only,address ranges will not be accepted) !HD USE ONLY <br /> FILES <br /> ❑X Underground Tank(UST) Street# Street Name city <br /> Cleanup Site(LOP) N T CONs... <br /> Other Cleanup Site(Non-LOP) <br /> 25485 ST RT 4 HY FARMINGTON <br /> y, t+'' <br /> Hazardous Waste HWIHM,AS� ( � 1 DAiN <br /> XJ Tiered Permitted Facility = 4469 E ESCALON BELLOTA RD FARMINGTON INGTON 5 ST— 0�C- <br /> ❑X Aboveground Tank _ <br /> ❑X UST (Monitoring/Removal) R`IPON - )I <br /> Q Hazardous Materials ST RT 120 HY ^"' S l Ta <br /> a 17000 1 <br /> )+M lAw ue�sr <br /> nX Spill/Release Response wl ArEn uALrY <br /> ❑X Sold Waste Facility/Vehicle 4 16636 E ST RT 120 HY RIPON � <br /> XJ Food Facility \ <br /> ❑X Pool/SpaIv SnE MMGATIGN <br /> Q Dairy 5 16996 �E ST RT 120 RIPON 1` <br /> ❑X Land Use Application Sites <br /> A/Il�./'rl Sir(cJ� � WSING <br /> Q Septic Pumper Tuck/ 6 21801 EST RD 120 HY ESCALON `��A/0��°�t n ���{y—� <br /> Yard I Chemical Toilets Hm iA U SP+4 ( J — By S 'v %+ <br /> Q Wastewater Treatment Plant -ITF T CUPA <br /> XJ Housing Abatement T 7950 S VAN ALLEN RD ESCALON AST/HM/HW <br /> XJ Motel/Hotel0tff bi <br /> CUPA <br /> ❑X Medical <br /> Dog Facility <br /> net 1851 VALPICO ROAD TRACY <br /> g UST <br /> Q Metlical Waste Facility <br /> ❑X Tattoo/Body Piercing FF r, SOLID WASTE <br /> Q Waste Tire 9`1 7357 S MURPHY RD RIPON <br /> nX Complaint <br /> Other(Please Specify): RIPON ❑AccoUNnNG <br /> ITvc M �? 7Oil 7428 S NORTH RIPON RD <br /> ***BOXED AREA-EHD USE ONLY*** <br /> I I Nan. Lov\42vc.,A 04- PRAA ,v ( nnc i w ov- owl` c :n1a1n e� o4- <br /> ❑ Records provided by Staff-PPR Complete. staff Name: EHU 46-06 <br /> 1868 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />