Laserfiche WebLink
SAN J OAQ U I N RECEIVEOvironmental Health Department <br /> - —COUNTY JAS 0 4 APUBLIC RECORDS RELEASE APPLICATION <br /> rr'efatrlr�:, �1rpor,yv; gyp,=r, <br /> ENVIRONMENTAL ti t- <br /> ,EgLTH EHD LOG NUMBER: <br /> OP776 I- <br /> APPLICANT: MEGAN MAUER 1SERVIGES BUSINESS/AGENCY: ESCREEN LOGIC <br /> ADDRESS: 11249 GOLD COUNTRY BLVD#165 CITY/STATEIZIP: GOLD RIVER, CA 95670 <br /> PHONE (1): 512-878055 PHONE (2): FAX OR E-MAIL: M.MAUER@DESCREENLOGIC.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 PROCESSED VIA EMAIL BY STAFF. DOM M DATE JANUARY 4, 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(u7sicehd.cam. 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 END 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 PERM? RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:001"M (EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List ❑ Map- Description: <br /> Specific Date Range of information Requested: From to <br /> ENVIRONMENTALFILE ADDRESS �,c�� ii <br /> HEALTH DEPARTMENT p HD USE ONLY <br /> FILES Sp ecific addresses and address ranges will not be accepted) <br /> E Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) ❑coNsuMER <br /> i <br /> Z Other Cleanup Site(Non-LOP) <br /> Hazardous Waste ❑DAIRY <br /> ®Tiered Permitted Facility 2 <br /> ®Aboveground Tank <br /> ®UST (Monitoring!Removal) � y(�j"r P <br /> G j ©PWs <br /> Hazardous Materials 3 2477 WIGWAM DR STOCKTON t� / <br /> Z Spill 1 Release Response N J cd( <br /> ®WATER Ql1A1RY <br /> ❑Solid Waste Facility/vehicle q <br /> ❑ Food Facility <br /> El Pool 1 Spa ®SM MITIGATION <br /> ❑ Dairy 5 <br /> ® Land Use Application Sites <br /> Septic Pumper Truck 1 ❑6 HousiNG <br /> Yard 1 Chemical Toilets <br /> I1 Wastewater Treatment Plant 0 CUPA <br /> ❑Housing Abatement 7 AST!HM 1 HW <br /> F1 Motel/Hotel <br /> Chicken Ranch/Dog Kennel ®CUPA <br /> [1 Medical Waste Facility <br /> UST <br /> Tattoo/Body Piercing <br /> ©souo WASTE <br /> Waste Tire g <br /> Complaint <br /> Other(Please Specify): ❑AccoumnNc <br /> 10 <br /> "BOXED AREA-EHD USE ONLY, <br /> 1/4/2018—EMAILED APPLICANT, CONFIRMED RECEIPT OF PRRA, INFORMED OF DELAY, AND WE HAVE FILES. DOM M <br /> ❑ Records provided by Staff-PPR Complete. staff Name: EHD 4&06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />