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RECEIVED <br /> SAN, JOAQUII Environmental Health Department <br /> COUNTY O 7 2018 PUBLIC RECORDS RELEASE APPLICATION <br /> Greotness growsEWA � YEMAIL <br /> 0 [70 <br /> PEMffr/SEfde1 EHD LOG NUMBER: <br /> APPLICANT: Manpreet Singh BUSINESS/AGENCY: <br /> ADDRESS: ' d4O Fant Main Strppt CITY/STATE/ZIP: (;tncktnn C-a gS7()S <br /> PHONE(1): 99 Sq1 dnRT� PHONE(2): 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 a pointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT �,�� /f � - DATE�Aarrh F �(11R <br /> 1. List up to ten addresses in the space below. Address ranges WILL NOT be accepted. Select the types)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 infoCdsicehd.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$162 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: El List Ef Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT ( p y 9 P ) EHD USE ONLY <br /> FILES (Specific addresses only,address ran es will not be acre ted <br /> gi Underground Tank(UST) Street# Street Name city <br /> Cleanup She(LOP) L]CONSUMER <br /> E]Other Cleanup Site(Non-LOP) ' 3440 E. Main Street Stockton <br /> ❑Hazardous Waste DAIRY <br /> Tiered Permitted Facility 2 <br /> ❑Aboveground Tank <br /> ❑UST (Monitoring/Removal Pws <br /> ❑Hazardous Materials a <br /> ❑Spill/Release Response1( WATER QUALITY <br /> I nn <br /> ❑ <br /> Solid Waste Facility/Vehicle y U <br /> ❑Food Facility <br /> Pool/Spa ❑SITE MmeATION <br /> Dairy e <br /> ❑Land Use Application Sites <br /> L]HOUSINGSeptic Pumper Truck I <br /> 8 <br /> Yard/Chemical Toilets <br /> ❑Wastewater Treatment Plant ❑CUPA <br /> ❑Housing Abatement 7 AST I HM I HW <br /> Motel/Hotel <br /> Chicken Ranch/Dog Kennel ❑CUPA <br /> Medical Waste Facility 8 UST <br /> Tattoo/Body Piercing 0 SOLID WASTE <br /> Waste Tire 8 <br /> ❑Complaint <br /> Other(Please Specify): ❑A. .TING <br /> to <br /> ***BOXED AREA-EHD USE ONLY*** <br /> G� <br /> M0.w\ rte ut- C" n a v <br /> Records provided by Staff-PPR Complete. Stud Name: Z,�,n� EHD48.06 <br /> 1868 E- Hazelton Avenue i Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www sjcehd com <br />