Laserfiche WebLink
a Eric Exton Fax:(888)501-3250 To:+12094640138 Fax: +12094640138 Page 1 of 1 08/012016 12:46 PM <br /> Ef. . ,.. I. _.. .,�Z <br /> _ 1�.: •' EHD IOG NUMBER <br /> . <br /> es <br /> SAN,ICAC CRN GOUtdTY <br /> �� AWN <br /> DEPAEAUG 0 l 2016 East�H iefign Avenue SEockton CA 95205 6232' <br /> Talephnner(205.)466 3420 Fak (249}'4.G4 01?B Weft www.sl9Pv org/ehd iii.. <br /> rRDfq NIT ttF FES FtlsL:14C; RECORDS LkLrt.SE AP6*tiCA[EON ' <br /> t7lC .. <br /> APPLICANT: - S'8x3 . . r� BUSII')ES$fACsEIaCYc c a;QS�o�`nG. <br /> ADDRESS ?LMX M(t1'C,jtie,�.Cil j sv� {�O- CITYJSTATEMP .LRSUQarNitls, 1 `7.7bS3 <br /> PHONE(1): Llt � <br /> ai (0647 YsDcSS :}„ 1f 2. ..F'NQhS'(z) FAKI'it'c E MAFt <br /> . ..�`Ttrdrew P C�(�i'aSPt cG� <br /> Pease allow 1Q btglriess daysfrom dat0.of application submittal for the records to be avail able. <br /> Staf#wtfl cpntaet you to.. <br /> ngea,tf 6urtment date and t(me to reviewthe requested reeords <br /> It 'gsrsx,6Nla _ uesc>eEsl2riis�i� s s <br /> SIGNATURE OF APPLICANT - .... ,- .. .._ DATE <br /> 9. Usf Uo to ten addresses in 1' sp a below Sslect the types)-of files from tllo list below by checking the appropriate <br /> box(es). At least one.file type=`MUST 6;1 seieebel, ax to i2fi91;464-0138�dF man to thea4dress Gidfcated above Address <br /> ranges will not be accepted AppI6 .ores re.. .+ d after 3:00'pimwtil-Be lSroces'6ed-the nexFbusin ess da <br /> y.- <br /> 2. For assistance in idenfifyfng'the nature.and conti of EHD.raco�ds piaEISG cotltact EtiD at the number-noted above. <br /> 3, The CHD will notify the applicant tf any iEHD files exist. An appointment fol review will:be confirmed approximately fen(10) <br /> days:after receipt of appl(cafion The tiles w11i be tie1Q for a maxlKnum of five:business hays fb:r review. Appointments <br /> should be scheduled:accordingiy - - <br /> 4. Any file not returned in that same condition'as released will be reorganized by.EHD staff at the'.expense of the applicant. <br /> Future file reviews by the saute apphcaht may require a$116 deposit prior to review4. <br /> WELL AND SEPTIC P.ERMIT RECORDS AREAV')4kKE POR REVIEW:f Mdiiiq :f,i?tDAY$AO;JIM5:08PM(EXCLUglfdrsH¢LIDAYS) <br /> Electronic information [ L75t (][Vlap Uescriptlon•': <br /> Specific Date Range 6f fn#cirnafion Req rested: Eiom to' <br /> -hie,u5r <br /> HEA."T;:t iEP.hTtTtxll FILE.ADDRESS <br /> USE ONLY <br /> UNDERGROUND TmK IIJST): Sfregi# Street Name 'Clip <br /> CLEANOP.SDE(LOP) .. NO. ❑CONsuHEP <br /> 1 <br /> ❑OTHER.^.IrNILIP SnE(NON-LOP) <br /> HA Dws WnsTE . . .. L <br /> ❑TIERED REWAITED FACILITY 1 /\ 11V4DAI2Y <br /> ASOVEiROVNDTANK <br /> Ia UST (MONT OW G/RENCX;L) ! (]PNS <br /> l�HA RDOU$MA E nA s 3 II <br /> SAUJRE:EASE RESPONSF. 1 IXCI <br /> ❑SOLIDwgsfE FAC1:rtV1V9iICY.E:. 4' w1TJi alulry /`'-J <br /> ❑FOOD FACILW 7 /J <br /> ❑POOL/SP1 .. .:: <br /> SOE W`K.RTON <br /> ❑ <br /> DAIRY a ... .. <br /> ❑LANO UEEA.PPLICATION SITEs., - <br /> SEPTIC 00.P TRUCK/ - HJuars <br /> fi. .. .. .7 <br /> YI.FO/OIEMIGAI TTMErs <br /> ❑WMTE%KwMR TREATTIINT PLANT _ <br /> �HouPawD AEATENENr .'! CVPA <br /> .. . <br /> ❑MOTEUMGTPI <br /> ❑CHICKEN RANCR l Doe.KENNEL <br /> COPA <br /> S . <br /> ❑MEDICAL WAaTE FACLLTM <br /> ❑TA'TOO/9ODY PIERCVIG <br /> ❑WASTE I IRE a ••. ❑SDI W.Ta <br /> ❑OTNER(PLEPvE SPECIFY): <br /> tp - ❑nett iw <br /> " "'BOXSDARFfi-EHD USE <br /> r <br /> ❑ Records provided by StafF-RRR CIDMP[ete.Staff Name: <br /> END 48-D6 - . . <br /> Received Time Aug. 1. 2016 10:45AM No. 1039: . <br />