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CEIVED <br /> • - OQQ Environmental Health Department <br /> C C _, i J T'r' 1PR 18 2018 PUBLIC RECORDS RELEASE APPLICATION <br /> G ENVIRONMENTAL <br /> PROM SERVICE IT BY EMAIL �G J 3 7 <br /> EHD LOG NUMBER: <br /> APPLICANT: KEVINJOHNSTON BUSINESS/AGENCY: <br /> ADDRESS: 2288 BUENA VISTA AVENUE CITY/STATEIZIP: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 tb ar "p ent date and time to review the requested records. <br /> SIGNATURE OF APPLICANT = n � - - DATE 4-13-18 <br /> 1. List up to ten addresses in th 9face below ress 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(2091464-0138, 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. 4 /Z� <br /> Future file reviews by the same applicant may require a $152 deposit prior to review. l <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:0013M(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List ❑ Map- Description: <br /> Specific Date Range of Information Requested: From ALL to PRESENT <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES (Specific addresses only,address ranges will not be accepted) EHD USE ONLY <br /> xj Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) "�T D LDp Corvsuasa <br /> x Other Cleanup Site(Non-LOP) ' 25485 E ST RT 4 HY FARMINGTON NOLMAO&O <br /> Hazardous Waste IiWIS'L Np Lo DAIRY <br /> x❑Tiered Permitted Facility 2 4469 E ESCALON BELLOTA RD FARMINGTON Landle <br /> a <br /> Qx Aboveground Tank <br /> Q UST (Monitoring/Removal) t E <br /> QX Hazardous Materials IPONLa <br /> 3 17000 ST RT 120 HY Rndes PWS <br /> X❑Spill/Release Response AM,NW Ultit SfWy <br /> FX Solid Waste Facility/Vehicle 4 16636 E ST RT 120 HY RIPON ^A 2u l / p "TEe aunun <br /> Q Food Facility I VV <br /> Ex Pool/Spa MITI°AMN <br /> Fx Dalry 5 16996 E ST RT 120 RIPON rwLA4gO <br /> ❑x Land Use Application Sites <br /> Q Septic Pumper Truck/ e 21801 E ST RD 120 HY E CALON -NO <br /> H°ua�rve <br /> Yard/Chemical Toilets HM to U 5,�,4 <br /> xj wastewater Treatment Plant AST/HNy NV.HWr Aff XAV CUPA <br /> Q Housing Abatement T 17950 S VAN ALLEN RD ESCALON AST/HM IHW <br /> Q Motel/Hotel l,dvm yMmwo LO <br /> QX Chicken Ranch 1 Dog KennelT RACY W W�duw CUPA <br /> Q Medical Waste Facility a 11851 VALPICO ROAD u1 DST <br /> XJ Tattoo/Body Piercing e <br /> a S MURPHY RD RIPON WIA"t"su S°"°W"ara <br /> x waste Tire 17357 <br /> Q Complaint Other( �f- <br /> PleaseSpecify ,e 17428 S NORTH RIPON RD RIPON �JO LpnAltS� pA°c°urvnrvc <br /> 5CC � I� <br /> AML <br /> ) / '"BOXED AREA-EHD USE ONLY—' <br /> ,NLfMC [ t (A/(i. O r 1 ; vNv/Mer 0 - <br /> e it <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: EHD 48-06 <br /> 1868 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />