Laserfiche WebLink
RECEIVED RGvd s-`+P' <br /> SAN JOAQUINr,� � 0 ��� Environmental Health Department <br /> -----COUNT Y---- PUBLIC RECORDS RELEASE APPLICATION <br /> IS <br /> - - �EMMITrl EMAIL <br /> EHD LOG NUMBER: <br /> APPLICANT: Megan Mauer BUSINESSIAGENCY:escreenLogic <br /> ADDRESS: 1221 S Congress Ave.Apt 238 CITY/STATE/ZIP:Austin,TX 78704 <br /> PHONE(1): 5128787055 PHONE(2): FAX OR E-MAIL: m.mauer@escreenlogic.com <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 mTT auerq7,escreeniogic con) DATE <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 info(a)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. <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: X❑ List❑X Map—Description: = ' <br /> Specific Date Range of Information Requested: From to i .� 't <br /> ENVIRONMENTAL FILE ADDRESS ',I- C ' IG (o-�q qit°" <br /> HEALTH DEPARTMENT ( p y 9 accepted) HD USE ONLY <br /> FILES <br /> (Specific addresses only, address ranges will not be acce ted "tea <br /> Q Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) E]CONSUMER <br /> 1 <br /> x❑Other Cleanup Site(Non-LOP) •l,�lV I r���fe eQ� �1� ;�fQ��(,�. <br /> 0 Hazardous Waste 0 1 t�yH r <br /> Q Tiered Permitted Facilit 6t'�� 2 8751 Hwy 12 V � t01 tw �� <br /> Q Aboveground Tank MMC//' kAL;T (� P U7 5 <br /> X]UST (Monitoring/Removal) t���L�1� _ ❑PWS <br /> Q Hazardous Materials tet"`N 3 I Cj O r <br /> Q Spill/Release Response <br /> ATER QUALITY <br /> Solid Waste Facility/Vehicle 4 8 8 — <br /> Food Facility <br /> El Pool/SpaSIT <br /> p E MITIGATION <br /> F-]Dairy6 8 -- <br /> Land Use Application Sites <br /> F1 Septic Pumper Truck/ 6 p E]HOUSING <br /> Yard/Chemical Toilets U <br /> ❑Wastewater Treatment Plant I(CUPA <br /> ❑Housing Abatement 7 AST/HM/HW <br /> ❑Motel/Hotel <br /> F-1 Chicken Ranch/Dog Kennel5t,11 11�W CUI C LIST Medical Waste Facility 8 wy <br /> F]Tattoo/Body Piercing U <br /> SOLID WASTE <br /> ❑Waste Tire 9 Wy <br /> Complaint <br /> Other(Please Specify): E]AccouNTING <br /> 17285 ru e a __ <br /> —BOXED AREA-EHD USE ONLY— <br /> A 18'. r u {' Ap <br /> / / t'r <br /> V I atm,48-06 <br /> y?5l 1z . <br /> 1868 E. Hazelton Avenue Stockto California w <br /> 5205 1 T 209 46 -3420 1 F 209 464- 138 1 ww .s cehd.co <br /> �-1�-( � pf()U. VV Co pan �4,�,�y�� <br />