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RECEIVED <br /> y.I.UI'IA. <br /> SANJOAQUIN8 22 2018 (?XtEnvi ro n mental Health Department <br /> COUNTY--ca1F�'�j pM PUB <br /> 08 <br /> RELEASE APPLICATION <br /> EtMIZOf�itAEfJilLLft RL X36010 <br /> Grecrness aror:s RI$ <br /> - BMIT BY EMAIL <br /> LER: <br /> APPLICANT: Ruben Mullins BUSINESS/AGENCY:California Regional Water duality Control Board <br /> ADDRESS: 11020 Sun Center Drive#200 CITYISTATE/ZIP:Rancho Cordova,CA 95670 <br /> PHONE(1): 530-417-7870 PHONE(2):916-4644652 FAX OR E-MAIL: ruben.mullins@waterboards.ce.gov <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT Ruben Mullins '"'86;a ,m DATE 2I22,2018 <br /> 1. List up to ten addresses in the space below. Address 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 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. <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) J <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT ( p y g p <br /> FILES (Specific addresses only,address ranges will not be accepted) EHD USE ONLY <br /> ❑x Underground Tank(UST) Street# Street Name city <br /> Cleanup Bite(LOP) 8095 Rio Blanco Road Stockton ❑ConsuMen <br /> � 1 <br /> Other Cleanup SRe(Non-LOP <br /> nx Hazardous Waste !_i MIN \5J"16S,_rs E]DAIRY <br /> [_1 Tiered Permitted Facility 2 rl 1-`i' <br /> Q Aboveground Tank -JA) �-+�-� ' <br /> I�UST (Monitoring/Removal) C� /n/ `C f ❑Pta'9 <br /> a r <br /> Q Hazardous Materials <br /> nX Spill/Release Response <br /> ATEft QUAL11 <br /> Solid Waste Facility/Vehicle 4 r ' <br /> E]Food Facility I— 6 <br /> Pool/SpaU n ,L S1E MmeATION <br /> F]Dairy 1 ��' W, <br /> ❑Land Use Application Sites <br /> ❑Septic Pumper Truck/ n 6 ('\,fy1 I f) (�*, ❑HOLDING <br /> Wt,�/JI ti _ ` <br /> Yard/Chemical Toilets <br /> ❑Wastewater Treatment Plant VUPA <br /> Housing Abatement 7 ASTIHM/HW <br /> Motel/Hotel <br /> ❑Chicken Ranch/Dog Kennel COPA <br /> Medical Waste Facility a UST <br /> ❑Tattoo/Body Piercing SOLID WAsre <br /> ❑Waste Tire 9 / <br /> Complaint V I 6 <br /> Other(Please Specify): 10 !' 1'1 J6 t'e ` �O I ❑Accowmnc <br /> '1 r ✓/ <br /> *" BOXED AREA-EHD USE ONLY*** <br /> (i- 'resile i13 - imek a fa ek anSL ive,Lwv�fa <br /> J. <br /> ❑ Records provided by Staff-PPR Complete. staff Name: EHDAIMS <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />