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b 13 18 10:28a Phase1Assessments 916-988-6639 p.1 <br />r. <br />RECEIVED <br />SAN I OAQ U I N FEB 13 2018 Environmental Health Department <br />•.--COUNTY EWPAAAEWALFE1 PUBLIC RECORDS RELEASE <br />jS�, 03 <br />I y, ,I � i �/-I EHD LOG NUMBER: APPLICANT: -<i TZ-Sr7I1L V /}-jt IL-1 BUSINESS/AGENCY: <br />ADDRESS; �.7,3 - y�A P/4l % C P 11 E' CITY/STATE€ZIP: /=f)! CnIM , /-A- C7 ti / ?i1 <br />0 <br />PHONE (1). C If i[Q.) �j%� rf-�o l PHONE (2): FAX OR E-MAIL :j0l�I y tom,, <br />Please allow 10 business days from date of -application submittal for the records to be available. <br />Staff will contact you to arra n -appointment date and time to review the requested records. <br />SIGNATURE OF APPLICANT_�,,. DATE <br />1. List up to ten addresses in the ace be of w. Addresft-ranges WILL NOT be accepted. Select the types) of files from the <br />list below by checking the appropriate box(es). At least o?lllll a type MUST be selected. Fax to (209) 464-0138, mail to the <br />address indicated below, or email to info(a)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 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 $152 deposit prior to review. <br />WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:001cM (EXCLUDING HOLIDAYS) <br />Electronic Information: ❑ List ❑ Map - Descri <br />Specific Date Range of Information Requested: From <br />to <br />HEALTENVHIRONMENTAL <br />DEPARTMENT <br />FILE ADDRESS <br />FILES <br />(Specincaddresses <br />only, address; rangeswill not <br />beaccepted) <br />EHD H -RE ONLY <br />Q <br />Undergmund Tarx(UST) <br />Street# <br />Street Name <br />City <br />i <br />� <br />�� , T11�' /l1 11 t , <br />Li Yrr i�iJ <br />Cleanup St. (LOP)El <br />O:her Cleanup Stte (Non -LOP) <br />I /\ r� I A <br />4lCV <br />° cousuuea <br />I.�': w �jp n <br />v"r <br />Haza Nous Wasle <br />Teered permleed Fadliry <br />T) U <br />1—I <br />ua <br />f�Vn6P icr� 1�, <br />2 <br />3 <br />�' �1'I <br />I�w <br />IxAbovegmund Tark <br />S <br />/tll/V1CI. �rylr! <br />J ( ,�r�.• <br />S' I �.Q/y'� <br />`/n <br />i _ <br />P- H W <br />W uSr (Monitadng l Removal) <br />6 G 1 ❑ py,/5 <br />V� <br />`q—M <br />© Harardous Matedak <br />a <br />•'T -I <br />30� <br />L r AIN Y^ `' � _ / <br />—€ �r t/L, 4CJC. N <br />5, �n <br />f <br />p <br />Qi Spill! Release response <br />Solid Waste Family f Vehicle <br />Food Facillly <br />(i <br />r &Z JZ <br />( [� <br />y <br />S <br />JI^ <br />-j/,e q' 1ne ` <br />&44 /I/Y f,'j'f//) <br />I AVVL <br />( <br />J f � <br />E] Pcol I Spa <br />Oslry <br />s <br />❑ sre Mlrlcnor. <br />lend Use Ap n.Kjon Stas <br />a <br />r <br />❑ Hoasga <br />Septic Pumper Truck I <br />YaN / Chemical Tareis <br />1 <br />❑ W using er Treatment Pian[ <br />Housing ADa:emenl <br />T <br />AST/H0.1IHw <br />Molel,Hotel <br />{,I <br />fJ`Na'` <br />Chicken ranch I Dog Kennel <br />Medical Waste Facility <br />e <br />/ <br />/ I ( <br />CUPA <br />UST <br />` V� <br />CAV <br />E]Taaoo/aody Fleming <br />❑ Wane Tire <br />9 <br />%I ❑ o Wisia <br />❑^ Complaint <br />Fl Other (Please specify): <br />10 <br />❑AeeWnnNG <br />o VACY ARCA - GHU USE ONLY' <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-34201 F 2D9 464-0138 1 wvvw.sicehd.com <br />Received Time Feb, 13. 2018 9:31AM No.3052 <br />'Lger <br />