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SAN.JOAQUINRECEIVFR, <br /> nvlronmental Health Department <br /> —COUNTY— APR 17 Zos PUBL�ICRECORDS RELEASE APPLICATION <br /> t <br /> Greaness Brows h> I ��;LA65 <br /> VEMM EHD LOG NUMBER- <br /> APPLICANT: Sadie Bodiford BUSINESS/AGENCY:Temacon Consultants, Inc. <br /> ADDRESS: 50 Goldenland Court,Suite 100 CITY/STATE/ZIP:Sacramento,CA 95834 <br /> PHONE(1): 916-246-5080 PHONE(2):916-926-4690 FAX OR E-MAIL: sadie.bodiford@temacon.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 apointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT Sadie Bodiford electronic signature) DATE 4-17-2018 <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(ZDsicehd.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. I� <br /> Future file reviews by the same applicant may require a$152 deposit prior to review. _ l( 7 <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 All to <br /> ENVIRONMENTAL FILE ADDRESS �. tt , 60• d'1 $`I <br /> HEALTH DEPARTMENT ( p y 9 p ) EHD USE ONLY <br /> FILES (Specific addresses onlyaddress ran es will not be acce ted <br /> ❑X Underground Tank(UST) Street# Street Name city <br /> Cleanup Site(LOP) UyZ © C suw,ER GQ <br /> • nX Other Cleanup Site(Ncn-LOP),� ' 8715 Grant Line Road West Trac/ w, NO r y <br /> 0 Hazardous WasteC lu�, // i/-1 <br /> Tiered Permitted Facility z 724. Grant Line Road East Tracy D /`• �✓ <br /> >hLv, U T <br /> ❑x Aboveground Tank ADZ <br /> ❑x UST (Monitoring/Removal) ❑PWS <br /> ❑x Hazardous Materials a <br /> ❑x Spill/Release Response <br /> Solid Waste Facility/Vehicle 4 WATER QNALITV <br /> Food Facility <br /> Pool/Spa STe MITIG(TION <br /> Dairy 6 <br /> ❑X Land Use Application Sites <br /> Q Septic Pumper Truck/ ❑Houslrvc <br /> 6 <br /> Yard/Chemical Toilets <br /> ❑Wastewater Treatment Plant CUPA <br /> ❑Housing Abatement 7 ASTIHM/HW <br /> F1 Motel/Hotel <br /> Chicken Ranch/Dag Kennel CUPA <br /> Q Medical Waste Facility 8 UST <br /> Tattoo/Body Piercing <br /> OLIO WASTE <br /> Waste Tire a <br /> N Complaint <br /> Other(Please Specify): p Accourvrwc <br /> t0 <br /> **'BOXED AREA-EHD USE ONLY*** <br /> • Lt-1 l 143' C Q n{+rr�e9 (- 8A_ 6- c z�ll <br /> r <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: I EHo 411 ON <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-34201 F 209 464-0138 1 www.sjcehd.com <br />