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f� 11 J O QUI, Environmer, ,l Health Department <br /> COUNTY---- NOV 0 3 20Y PUBLIC RECORDS RELEASE APPLICATION <br /> Greatness grows " EWRONME+TALBEEM I �""t <br /> pERMIT/SERMES EHD LOG NUMBER: <br /> APPLICANT: LYNN KINDER BUSINESS/AGENCY: <br /> ADDRESS: 1725 DAVIS LN CITY/STATE/ZIP: RENO, NV 89511 <br /> PHONE (1): 775-240-9201 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 appointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT PROCESSED VIA PHONE BY STAFF. DOM M DATE NOVEMBER 3, 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 <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 infoPslcehd.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. ,, I• i <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) V <br /> Electronic Information: ❑ List❑ Map— Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT y 9 accepted) EHD USE ONLY <br /> FILES (Specific addresses only, address ranges will not be acce ted <br /> ®Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) "1 ®CONSUMER <br /> 1 1010 INDUSTRIAL DR STOCKTON �V <br /> ®Other Cleanup Site(Non-LOP) <br /> ®Hazardous Waste ®DAIRY <br /> ®Tiered Permitted Facility 2 <br /> ®Aboveground Tank <br /> ®UST (Monitoring/Removal) <br /> ❑PWS <br /> ®Hazardous Materials s <br /> ®Spill/Release Response <br /> ®WATER QUALITY <br /> ®Solid Waste Facility/Vehicle 4 <br /> ®Food Facility <br /> ®PoDI I Spa �0 ®SITE MmcanoN <br /> ®Dairy 6 <br /> ®Land Use Application Sites <br /> HOUSING <br /> ®Septic Pumper Truck/ ® <br /> s <br /> Yard/Chemical Toilets <br /> ®Wastewater Treatment Plant 1 (,,t3 ®COPA <br /> ®HousingAbatement 7 AST/HM/HW <br /> ®Motel/Hotel <br /> ®Chicken Ranch/Dog Kennel ®CUPA <br /> 1 <br /> ®Medical Waste Facility $ UST <br /> Tattoo/Body Piercing <br /> l ®SOLID WASTE <br /> ®Waste Tire s N <br /> ®Complaint <br /> ® Other(Please Specify): ®AccoUNTING <br /> SEPTIC&WELL PERMITS,OUTSANDING FEES 10 <br /> ""BOXED AREA-EHD USE ONLY*** <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: EHD 4e-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 F 209 464-0138 1 www.sjcehd.com <br />