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C <br /> SEI ED Environmental Health Department <br /> COUNTY- L4111� <br /> N O DR Q i PUBLIC RECORDS RELEASE APPLICATION EI)MROfVMENTAL H BAIT eY EMAIL 93 503 7 <br /> PERMIfISERVICE EHD LOG NUMBER: <br /> APPLICANT: KEVIN JOHNSTON BUSINESS/AGENCY: <br /> ADDRESS: 2288 BUENA VISTA AVENUE CITYISTATEIZIP: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 arrange to ent 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 ace below dress 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 (20914640138, 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 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. <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 p H D USE ONLY <br /> FILES rN <br /> �y(S ecific addresses only, ranges will not be accepted) <br /> FX-1 Underground Tank(OST) j Street# Street Name City <br /> Cleanup Site(LOP) N .T CONSUMER <br /> ' <br /> X Other Cleanup Site{Nan-LOP} 25485 E ST RT 4 HY FARMINGTON d <br /> X Hazardous Waste <br /> Q Tiered Permitted Facility 2-4469 E ESCALON BELLOTA RD F INGTON S S� 4f;NLJ <br /> ❑ <br /> X Aboveground Tank <br /> ❑x UST (Monitoring!Removal) ST RT 120 HY R`1 PON '�' � s J <br /> s 17QQ0 P%G�'nr <br /> Hazardous Materials <br /> lai"t 11W tlSiyPw�i �G <br /> I]Spill 1 Release Response ;a,t � Area uauly <br /> Q Solid Waste Facility 1 Vehicle 4 16636 E ST RT 120 HY RIPON <br /> Q Food Facility �i <br /> I�Pool t Spa 1 SnE MIT1GAilON <br /> Dairy <br /> 5 16996 �E ST RT X20 RIPON <br /> Q Land Use Application Sites <br /> 12"lVjTl y f,t1i A V f P „r1/ �,L t�� 6G�l Hou"Nc <br /> QSeptic Pumper Truck 1 5 21801 E ST RD 120 HY ESCALON pf� S <br /> Yard!Chemical Toilets i 1M t 1i�v1 —i4 ! I f V i <br /> Q Wastewater Treatment PlantI r I L r CUPA <br /> QHousingAbatement 7 7950 S VAN ALLEN RD ESCALON AST IHMIHW <br /> X❑MotellHctel PC Ld' <br /> Cl1PA <br /> Q Medic l Wanchste Fa og ility el 1851 VALPICO ROAD TRACY <br /> g UST <br /> Q Medical Waste Facility <br /> 0 Tattoo/Bedy Piercingr SOLID WASTE <br /> oWaste Tire 9` 1 7357 S MURPHY RD RIPON <br /> I]Complaint <br /> �.Other(Please Specity): r RIPON 0 AccouNnNc <br /> 10 17428 TNORTH RIPON RD <br /> —BOXED AREA-EHD USE ONLY` f <br /> I'1-1 'Wil +-rN✓�1`1V :i �..'�F c7-�- il1V-� ,i v��fMC� L , L1/l�. L"�l Ll.. - L •h iv]I M�•i D'{`. <br /> ❑ Records provided by Staff-PPR Complete. staff Name: EHD 48-06 <br /> 1868 F. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 www.sicehd.com <br />