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4 <br />SAN.,JOAQUSN RECEIVWvironmental Health Department <br />C O (_I I'd T -- APR 3 0 2018 PUBLIC RECORDS RELEASE APPLICATION <br />ENVIRONMENTAL HEALTH 1 EHD LOG NUMBER:88633 <br />DGD//ITlnrrn n*. �.. <br />"APPLICANT: SCOTT BITTINGER BUSINESS/AGENCY: STRATUS ENVIRONMENTAL <br />ADDRESS: 3330 CAMERON PARK DR, STE 550 CITY/STATE/ZIP: CAMERON PARK, CA 95682 <br />PHONE (1): 530-676-2062 PHONE (2): 916-601-9756 FAX OR E-MAIL: <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 PROCESSED VIA PHONE BY STAFF. DOM M DATE APRIL 30, 2018 <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(cDsicehd.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: ❑ List ❑ Map — Description: <br />Specific Date Range of Information Requested: From to <br />ENVIRONMENTAL <br />FILE ADDRESS <br />tlyJ'C C0- � <br />HEALTH DEPARTMENT <br />FILES <br />(Specific addresses <br />(p <br />only, address ranges will not <br />y s <br />be accepted) <br />p <br />EHD USE ONLY <br />® Underground Tank (UST) <br />Street # <br />Street Name <br />City <br />Uy_ 0 17� CONSUMER <br />Cleanup Site (LOP) <br />®Other Cleanup Site (Non -LOP) <br />7 <br />2070 <br />SEL DORADO ST <br />STOCKTON <br />5 Z n <br />1X <br />DAIRY <br />Hazardous Waste <br />® Tiered Permitted Facility <br />2 <br />UST, HW, CO <br />® Aboveground Tank <br />❑ PWS <br />® UST (Monitoring / Removal) <br />® Hazardous Materials <br />3 <br />® Spill/ Release Response <br />® WATER DUAL" <br />❑ Solid Waste Facility / Vehicle <br />4 <br />❑ Food Facility <br />® SITE MITI <br />❑ Pool / Spa <br />❑ Dairy <br />6 <br />Land Use Application Sites <br />❑ Hcuslxc <br />❑ Septic Pumper Truck / <br />6 <br />Yard / Chemical Toilets <br />❑ Wastewater Treatment Plant <br />® CUPA <br />❑ Housing Abatement <br />T <br />AST/HMIHW <br />❑ Motel/Hotel <br />® CUPA <br />❑ Chicken Ranch / Dog Kennel <br />F1Medical Waste Facility <br />a <br />UST <br />❑ Tattoo/Body Piercing <br />p SOLID WASTE <br />❑ Waste Tire <br />9 <br />® Complaint <br />❑ AccouNTRG <br />❑ Other (Please Specify): <br />10 <br />"*BOXED AREA - EHD USE ONLY*** <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />CA <br />