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ECEIVED <br /> SAN : J OA Q UFEB � 7 2p1� Environmental Health Department <br /> - - COUNT r PUBLIC RECORDS RELEASE APPLICATION <br /> 2-ot <br /> ENVIRONMENT <br /> PERMITfSERNIEMIAfL EHD LOG NUMBER: Ufa� .. <br /> APPLICANT: Michel Helou BUSINESSIAGENCY:Panner ESI <br /> ADDRESS: 1017 22nd Avenue,Suite 107 CITYISTATEIZIP:Oakland, California 94606 <br /> PHONE(1): 508-858-5583 PHONE(2):774-721-3007 FAX OR E-MAIL: mhelou@pailneresi.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 DATE 212712018 <br /> 1. List up to ten addresses in the space below. Address ranges WILL NOT be accepted. Select the types)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@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. `➢1 <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM•5:00PM(EXCLUDING HOLIDAYS) } <br /> Electronic Information: ❑ List ❑ Map—Description: <br /> Specific Date Range of Information Requested: From 1940 to Present <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT y 9 p <br /> FILES (Specific addresses only, ranges will not be accepted) EHD USE ONLY <br /> 0 Underground Tank OST) Street# Street Name City <br /> Cleanup Site(LOP) ❑CONsuannn <br /> �• <br /> Other Cleanup Site(Non-LOP) t 14749 North Thornton Road Lod _L.l <br /> 0 Hazardous Waste $ �� Ir�7� DAIRY <br /> F-1TieredPermitted Facility 'P 2 14659 North Pennant Road Lodi <br /> Q Aboveground Tank <br /> UST (Mentoring!Removal) t/J., ,° v ! []PWS <br /> 0 Hazardous Materials e <br /> FX�Spill!Release Response cw <br /> Solid waste Facility f Vehicle q ATEn gvnl.lry <br /> Food Facility <br /> ❑Oapry!spa $ j SITE MIT1GATlON <br /> Q Land Use Application Sites <br /> Septic Pumper Truck 1 ❑HOUSING <br /> Yard!Chemical Toilets <br /> Gil ` e <br /> Wastewater Treatment Plant ^ �/ � n. <br /> ✓1�yT rpt `� /1 <br /> Housing Abatement 7fJ( <br /> ❑MotelfHotel V , , <br /> Chicken Ranch!Dog Kennel <br /> CUPA <br /> Medical waste Facility <br /> $ UST <br /> ❑Tattool[3ody Piercing <br /> []SOLIP WASTE <br /> F1 waste Tire y <br /> Complaint <br /> Other(Please Specify): AccouwING <br /> 30 <br /> "'BOXED-AREA-EHD USE ONLY— <br /> E4 4r el to 0 PMA ° e dt0,1172--�j <br /> I <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: EHD 48-06 <br /> 11161 E. Hazelton Avenue I Stockton, California 9,52111 T 209 468-3420 1 IF 209 464-0138 1 www.sjcehd.com <br />