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RECEIVED <br /> SAN JOAQUIN Environmental Health Department <br /> COU NTv MAT 16 2018 PUBLIC RECORDS RELEASE APPLICATION <br /> • _ . Gsc rne;s :; 1�.:; ;�� a AA <br /> 0. <br /> —FfaEilU /y-111 A `EHD LOG NUMBER:18 V 17 <br /> APPLICANT: RweHesanzuela BUSINESSIAGENCY:Sei consulting services.tad. <br /> ADDRESS: WON.LakeA.e St, 460 CITY/STATHZIP:Pasadena.CA 91101 <br /> PHONE(1): am<os3618 PHONE(2):626568-6056 FAX OR E-MAIL: —allobenzuaidgeuntec.adn <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 `fr-z(�k cr ,.�,(� DATE 51162.16 <br /> 1. List up to ten addresses in the space bek, . Address ranges WILL NOT be accepted. Select the type(.)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 infoidsic llu 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 atthe 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$162 deposit prior to review. 7 <br /> WELL ANO 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 tune to Present <br /> ENVIRONMENTAL FILE ADDRESS —C4� tba'-T'ra�7.,{OrYTI <br /> HEALTH DEPARTMENT IY 0 accepted) EHD USE ONLY <br /> FILES (Spedficatltlresses on address ranges will not be ecce tetl <br /> Ox Undergmund Tank(UST) streetStreet Name city <br /> champ Site(LOP) SBP fl\Nf ❑cami <br /> • Ox Other Cleanupsteflm-LDP, 1721 W. Yosemite Ave. Manteca nD <br /> 0 Heramous Waate <br /> ❑Quer <br /> Ox rrerea Parmmea Fadury z <br /> Ox Aboyegmu d Tank ( KW 5N1 <br /> 0X UST (Monitoring l Remo,sh 0PW5 <br /> Q Hazardous Materials a <br /> 0X Spill I Reteaee Response <br /> 0 Sold Waste Facility I Vehicle 4 g;CATeRdi <br /> 0 Food Fac iey <br /> 0 Pool I Spa gans MRYTpx <br /> 0 Dairy 5 <br /> 0 Land Use Application Slope <br /> 0 Sets Pumpm Tnxk I6 ❑H.s. <br /> Yard I Chemical Toilets <br /> 0 Wastewater Treatment Rant pppA <br /> O Housing Abatement r ASTIHMIHW <br /> 0 stmelMotel <br /> Chicken Pri I Dog Hamel OUPA <br /> 0 Medical Waste Fac fty a UST <br /> Tatlwla00y Piemin8 <br /> ❑SwpW <br /> Waste Tire q <br /> OX Complaint <br /> 0 Other(Please Specify): D essadm ne <br /> ap <br /> n —BOXED AREA-EHO USE ONLY"' <br /> ❑ Records rovitied by Staff-PPR Complete.Spurt Nam.: EHDae.oa <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-34201 F 209 464-0138 1 warw.sicehd.com <br />