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■ % %W 0.■ W \.V <br /> DATE RECEIVED EHD LOG NUMBER <br /> {e� SAN .IOAQUIN COUNTY <br /> JUN lC 6111 of{ 3Pr_' ENVIRONMENTAL HEALTH DEPARTMENT 86536 <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �AIr� : (209)468-3420 Fax: (209)464-0138 Web:www.sicehd.com Email: infoCa),sicehd.com <br /> PENAIT/S"C S PUBLIC RECORDS RELEASE APPLICATION <br /> OPPLICANT: Paul Parker BUSINESS/AGENCY:­Hopf Environmental <br /> ADDRESS: 10356 N Country Rd 950 E CITY/STATE/ZIP: Brownsburg, IN 46112 <br /> PHONE (1): 317-677-2960 PHONE (2): FAX OR E-MAIL: parker@envirohopf.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 /> ❑ CHECK BOX TO EXPEDITE REQUEST-$139 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT Processed via email by staff. Dom M DATE June 21,2017 <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 list <br /> 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 above, or email to info(rDsicehd.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 above. <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 $139 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: ❑ List❑ 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 /> ®UNDERGROUND TANK(UST) Street# Street Name city <br /> CLEANUP SITE(LOP) ❑CONSUMER <br /> + <br /> OTHER CLEANUP SITE(NON-LOP) 192 Lathrop Rd Lathrop <br /> ®HAZARDOUS WASTE I, DAIRY <br /> ®TIERED PERMITTED FACILITY 2 14000 E Hwy 88 Lockeford � U/1Y <br /> ®ABOVEGROUND TANK <br /> ®UST (MONITORING/REMOVAL) []PWS <br /> HAZARDOUS MATERIALS B 1434 W Yosemite Ave Manteca — <br /> ® <br /> ®SPILLIRELEASE RESPONSE <br /> ❑ ®WATER QUALITY <br /> $OLIO WASTE FACILITY/VEHICLE 4 I'l3l'�1 <br /> ❑FOOD FACILITY 11 1 I C9 �✓I/1 <br /> F1 POOL/SPA t/✓ r t®Y SITE MmGanON <br /> ❑DAIRY B <br /> ❑LAND USE APPLICATION SITES <br /> HOUSING <br /> F1SEPTIC PUMPER TRUCK/ S <br /> YARD/CHEMICAL TOILETS <br /> ❑WASTEWATER TREATMENT PLANT ®CUPA <br /> ❑HOUSING ABATEMENT 7 <br /> MOTEL/HOTEL <br /> ❑CHICKEN RANCH/DOG KENNEL ®CUPA-UST <br /> B <br /> ❑MEDICAL WASTE FACILITY <br /> ❑TATTOO/BODY PIERCING SOLID WASTE <br /> ❑WASTE TIRE 9 <br /> ®COMPLAINT <br /> ❑OTHER(PLEASE SPECIFY): ACCOUNTING <br /> 10 <br /> "'BOXED AREA-EHD USE ONLY" <br /> 6/21/2017–Emailed applicant to confirm receipt of application. Dom M <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br />