Laserfiche WebLink
RECEIVED <br /> SAN AQ N 144)' 3 0 2-6lrnvironmental Health Department <br /> - - ---- <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> C 0 U N T Y . <br /> EWR0WAEN'T1Ai. H&%LTtt �1 _ud <br /> PEiMi !�'�' <br /> AIL <br /> 5-�eM EHD LOG NUMBER: <br /> APPLICANT: Lyna Black BUSINESS/AGENCY:Jacobs <br /> ADDRESS: 2525 Alr Park Drive CITY/STATE/ZIP:Redding,CA 96001 <br /> PHONE(1): 530-229-3295 PHONE(2):530.680-5276 FAX OR E-MAIL: lynablack@jacobs.com <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will Contac you to mr a an appointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT DATE DATE j/ t' _ <br /> 1. List un to ten addresses in the4pace below. Address ranges WILL NOT be accepted. Select the typ)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. <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 L,Nf;t }} c+.c r_k to r11L4 <br /> ENVIRONMENTAL FILE ADDRESS 2Ct� W7_1 1T <br /> HEALTH DEPARTMENT y g p ) EHD USE ONLY <br /> FILES {Specific addresses only,address ran es will not be acre ted <br /> Underground lank(UST) Street# Street Name City �WW_///��� <br /> Cleanup Site(LOP) !"k (Q� 11 CONSUNER <br /> Other Cleanup Site(Non-LOP) 1 UlOt7 W �`�,}r i P <br /> kA <br /> Hazardous Waste <br /> E]Tiered Permitted Facility 2 <br /> aAboveground Tank 2� J M�r-Q C i.t (�( } <br /> UST (Monitoring l Removal) �,h E3Pws <br /> sT <br /> ®Hazardous Meledals LO 0 <br /> t 33 Tc -,,s { �, <br /> ®;Spill l Release Response oA rFR 011A I in <br /> ❑Solid Waste Facility I vehic'* - q[' <br /> ❑Food Facility (D44i"o, Lt" t! � f � o D S <br /> ❑Pool I Spa ilm►{' ®Stre Mnr+noN <br /> Dairy �`- It �_�T <br /> ❑Land Use Application Sites (C?J <br /> HOUSING <br /> F1 Septic Pumper Truck I <br /> ()k <br /> Yard I Chemical Toilets l) S. It )I-kz� <br /> Wastewater Treatment Plant` _ Nh�AW ©GUPA <br /> Housing Abatement AST I HM I HW <br /> ❑Motel[Hotoi <br /> Chicken Ranch I Dog Kennel ®GUST <br /> a UST <br /> Medical Waste Facility <br /> TaHoolBody Plercing Souo WASTE <br /> Waste Tire B <br /> Complaint <br /> Other(Please Specify) C]ACCOUNTING <br /> sa FT <br /> }, <br /> —BOXED AREA-EHD USE ONLY"' <br /> kp <br /> 2- � !ri � d, <br /> 0 Relcords provided by Staff-PPR Complete. Staff Name: t(A/I L(?Q G EHD"a <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />