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RECEIVED <br /> SAN J O A Q U I N MAY 3 0 WilEnvironmental Health Department <br /> -y- <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> CCU Nil EWRONME.NTAL HEALTH <br /> • Grcoti-,ess �jrows here PE?WITFWgf&AlL EHD LOG NUMBER: <br /> APPLICANT: Lyna Black BUSINESSIAGENCY:Jacobs <br /> ADDRESS: 2525 Air Park Drive CITY/STATE/ZIP:.Redding,CA 96001 <br /> PHONE(1): 530-229-3295 PHONE(2):530-680-5276 FAX OR E-MAIL: lyna,t)lack@jacobs.com <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contac you to e an appointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT '=' — DATE �;/Eoltf-"' <br /> 1. List up to ten addresses in the pace below. Address ranges WILL NOT be accepted. Select the typb(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 lnfop_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 hold 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 PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> Electronic information: El List Ej Map—Description: <br /> Specific Date Range of Information Requested: From -k to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT <br /> FILES (Specific addresses only,address ranges will not be accepted) EHD USE ONLY <br /> Underground Tank(UST) Street# Street Name city <br /> -ti <br /> Cleanup Site(LOP) ll [] ONSUWEF- <br /> 't)A�7. <br /> Other Cleanup Silo(Non-LOP) 101bL:) a <br /> Hazardous Waste <br /> Tiered Permitted Facility 2 <br /> q1T[ 4 <br /> )ZAbovegrotind Tank *Z'1S� Mq,-A( 4— \,/0C 13 Pws <br /> Ta,UST (Moniloting/Ramoval) <br /> f>_j Hazardous M8181112113 32%-J3 1 <br /> ,Spill/Release Response "'.ER OLFAUTY <br /> n Solid Waste Facilfty I Vel)104 I 4 <br /> ❑Food Facility loqqA to, l (Ai_Si, <br /> ❑Pool!Spa Gasim.MTTrAT1ojq <br /> Dairy <br /> ❑Land Use Application Siles0 Houswo <br /> Septic Pumper Truck/ <br /> Yard I Chemical Toilets 'A cu 1)11� [a'cUPA <br /> o wastewater Treatment Plant ASTIHMIHW <br /> ❑Housing Abatement <br /> Motel/Hotel <br /> WICUPA <br /> fChicken Ranch I Dog Karpal <br /> UST <br /> n medical Waste Facility <br /> Tattoo/Body Piercing 13 SOUD WASTE <br /> Waste Tire 9 <br /> Complaint 0 ACCOUNTINO <br /> E]other(Please Specify) <br /> to <br /> —BOXED AREA-EHD USE ONLY— <br /> MIA. F- <br /> 0 Records provided by Staff-PPR Complete. Staff Name: eHD 48 06 <br /> 1868 E. Hazelton Avenue I Stockton,California 95205 T 209 468-3420 1 F 209 464-0138 1 vAvw.sjcehd.com <br />