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RECEIVED <br /> S A N J O A Q U l N Environmental Health Department <br /> - <br /> COUNTY— tvid 16 2016 PUBLIC RECORDS RELEASE APPLICATION <br /> ,1:1. ,r tlrL herEWRO yRYBYe1AIL ( �QQ (A <br /> PEt NiMm 7t-\" EHD LOG NUMBER: <br /> APPLICANT: Melanie Manotti BUSINESSIAGENCY:Paladin Law Group,LLP <br /> ADDRESS: 1176 Boulevard Way CITYISTATEIZIP:Walnut Creek,CA 94595 <br /> PHONE(1): 925-947-5700 PHONE(2): FAX OR E-MAIL: mmanotti@paladinlaw.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 Melanie A.Madotti 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(dsicehd.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 1950 to present <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT ccepted) <br /> FILES (Specific addresses only, address ranges will not be aEHD USE ONLY <br /> x❑Underground Tank(UST) Street# Street Name city <br /> " ❑CorvsuMEa <br /> Cleanup Site(LOP) M <br /> • ❑x Other Cleanup Site(Non-LOP <br /> 416 W. Yosemite Ave. Manteca L�/co <br /> ❑x Hazardous Waste 5r^ 1 ❑DAIRY <br /> Tiered Permitted Facility = 420 W. Yosemite Ave. MantecaL ,Lu)ro <br /> R Aboveground Tank (�J <br /> ❑PWS <br /> Q UST (Monitoring/Removal) <br /> 3 <br /> Q Hazardous Materials <br /> Z Spill/Release Response ATER nUALll <br /> ❑Solid Waste Facility/Vehicle 4 <br /> ❑Food Facility mE MImGAnON <br /> ❑Pool/Spa <br /> Dairy <br /> ❑Land Use Application Sites [3 HOUSING <br /> ❑Septic Pumper Truck/ 6 <br /> Yard/Chemical Toilets <br /> CUPA <br /> F1Wastewater Treatment Plant <br /> AST I HM I HW <br /> [:]Housing Abatement 7 <br /> ❑MotellHOtel CUPA <br /> Chicken Ranch/Dog Kennel UST <br /> Fj 6 <br /> Medical Waste Facility <br /> ❑Tattoo/Body Piercing ❑SOLID WASTE <br /> ❑Waste Tire 9 <br /> Q Complaint <br /> Other(Please Specify): ❑Aceourvnme <br /> 19 <br /> f I - **`BOXED AREA-EHD USE ONLY"' <br /> ❑ Records provided by Staff-PPR Complete. staff Name: A2 <br /> EHp4806 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 F 209 464-0138 1 www.sjcehd.com <br />