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RECEIVE0 <br /> _ SA NAM I NI Environmental Health Department <br /> ' <br /> ----COUNTY-- JAN 1-' 2018 PUBLIC RECORDS RELEASE APPLICATION <br /> rF.�� t i3r�atn:ss yrar.5 her fV'ViRONMEWAL 11HIMEN ��� <br /> Rif INlITISI 'Ii ES EHD LOG NUMBER: <br /> 34 <br /> APPLICANT: Wendy Bellah BUSINESSIAGENCY: Terraphase Engineering <br /> ADDRESS: 1404 Franklin Street, Suite 600 CITYISTATEIZIP: Oakland, 4 <br /> 612 <br /> PHONE (1): 510-645-1850 x83 PHONE(2): 415-314-0368 FAX OR E-MAIL: wend Y.bell ahaOterraphase.cam <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contacran a an a of nt ate and time to review the requeste4 records. <br /> SIGNATURE OF APPLICANT DATE `�2— 7 <br /> 1. List up to ten addresses i h space bel . Ad ress ranges WILL NOT be accepted. Select the type(g)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@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 EMD 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 'l <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List 0 Map-Description: <br /> Specific Date Range of Information Requested: From 1900 to current <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 /> Cleanup Sita(LOP) (� Q CoNsuMER <br /> Other Cleanup Site(Nan-LOPS t 757 East 11th 5t. Tracy u)D <br /> ®Hazardous waste I� I h/` 4+ P J!+p_ _ ^, q DAIRY <br /> Tiered Permitted Facllity z 2401 N.MacArthur Drive Tracy 't•�'"l ry n ! lY`�/r r � <br /> ®Aboveground Tank Y <br /> /J ` Q <br /> UST {Monitoring!Removal} PWS yr f <br /> 3 <br /> F Hazardous Malerials ^ <br /> ❑Spill!Release Response <br /> KfWATERQUALRY <br /> Solid waste Facility!Vehicle 4 <br /> I]Food Facility <br /> Pool!Spa 7 E=7 <br /> QSnE MITIGATION <br /> Dairy d 75 cL —� �l��f� <br /> ❑Land Use Application Sites <br /> LJ <br /> �SING <br /> Septic Pumper Truck! a <br /> Yard 1 ChemlcaS Toilets <br /> ❑Wastewater Treatment Plant 81GLIPA <br /> F-1 Housing Abatement 7 K <br /> � ASTIHMrNW <br /> Motel/Hotel <br /> Chicken Ranch f Dog Kennel /` Q CUPA <br /> 8 f UST <br /> rlMedical waste Facility <br /> F1 Tahooh3ody Piercing Q SOUR WASTE <br /> F1 waste Tire g <br /> ❑Complaint <br /> ❑Other(Please Specify); Q A[z oUNFlNG <br /> 7n <br /> ***BOXED AREA-EHD USE ONLY*** <br /> 445 <br /> D Records provided by Staff-PPR Complete. Staff Name: EHD 4E.os <br /> 1868 E. Hazelton Avenue 1 Stockton, California 952051 T 209 468-3420 1 F 209464-0138 1 www.sjcehd.com <br />