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SAN J d A 0 IVED Environrnev Health Department <br /> -- --COUNTY - APR 18 2018 PU R O PYASE APPLICATION <br /> IE8�WR&N1yENTAL H 0(35737 <br /> HERMIT/SERVICEIT BY EMAIL <br /> EHD LOG NUMBER: <br /> APPLICANT: KEVIN JOHNSTON BUSINESS/AGENCY: <br /> ADDRESS: 2288 BUENA VISTA AVENUE CITY/STATE/ZIP:LIVERMORE CA 94550 <br /> PHONE (1): 9254475200 PHONE(2): FAX OR E-MAIL: CAT416CIT@GMAIL.COM <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arranged appofnftent date and time to review the requested records. <br /> SIGNATURE OF APPLICANT DATE 4-13-18 <br /> 1. List up to ten addresses in th�q ace 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(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 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, LA <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 ALL to PRESENT <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT ( p y 9 accepted) t-, EHD USE ONLY <br /> FILES (Specific addresses only,address ranges will not be acce ted <br /> ❑x Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) ct T <br /> E S T RT 4 H Y °NSUMER <br /> ❑/, Other Cleanup Site(Non-LOP) 25485 FARMINGTON <br /> Hazardous Waste I-AWi14M�N'i7 'Plj 1 []r DAIRY <br /> ❑X Tiered Permitted Facility 2 4469 E ESCALON BELLOTA RD FARMINGTON <br /> Q Aboveground Tank Lk _ <br /> X❑UST (Monitoring/Removal) .yt/4i v✓t17Al�/}�lr PWS <br /> ❑X Hazardous Materials 7000 ST RT 120 HY RIPON <br /> I'I",IAA k k 517 <br /> X❑Spill/Release Response � ''� <br /> QX Solid Waste Facility/Vehi e 4 16636 EST RT 120 Hy RIPON D ATER QUALITY <br /> ❑X Food Facility It)'#) ' <br /> V (((3333____ I• ___ ____ � <br /> ❑X Pool)Spa E S T RT 12 0 RIPON C� o SITE MITIGATION <br /> ❑X Dairy 5 16996 <br /> ❑X Land Use Application Sites / y /� <br /> h' � TI I, WrTi' ocafn-rcq �. ©HOUSING <br /> X❑Septic Pumper Truck/ 6 21801 E ST RD 120 HY ESCALON <br /> Yard/Chemical Toilets Flt�t 1 L J U1h`i4 <br /> X Wastewater Treatment Plant nA <br /> CUPA <br /> QHousing Abatement 717950 S VAN ALLEN RD ESCALON � AST/HM/HW <br /> Q Motel/Hotel <br /> FX_ Chicken <br /> icalWRanch/Faciliog ty <br /> Kennel 11851 VALPICO ROAD TRACY � � l9 CUPA <br /> s <br /> Q Medical Waste Facility UST <br /> Q Tattoo/Body Piercing r <br /> 0waste Tire 9 17357 S MURPHY RD RIPON BY SOLID WASTE <br /> X❑Complaint <br /> ©.Other(Please Specify): ❑ACCOUNTING <br /> �P ,t (' "+ L17428 S NORTH RIPON RD RIPON <br /> ***BOXED AREA-EHD USE ONLY*** <br /> Ol PPPA. 4;th-F1I_ WV % w?� 0'll,61 1i_ ,-V%4J 0"& 04- <br /> &a"'-, <br /> - <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: EHD 48-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />