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sQN ,��QQUI F� Lnmen' Health Department <br /> COUNTY= 2o1PUBLIC RECur�DS RELEASE APPLICATION <br /> oct.Greotr+ess grows he, 8745 <br /> ENV]RONMENTALVrMTN EHD LOG NUMBER: <br /> "'eeir-n�crF <br /> APPLICANT: ANNE DUMA BUSINESS/AGENCY: PK DATA INC <br /> ADDRESS: 5975 SHILOH RD,STE 114 CITY/STATE/ZIP: ALPHARETTA <br /> PHONE (1): 770-931-9677 PHONE (2): 678-640-0129 FAX OR E-MAIL: COMMERCIALPOOLS@PKDATA.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 an appointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT PROCESSED VIA EMAIL BY STAFF. DOM M DATE OCTOBER 30, 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 info(d)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 to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT ( ponly, 9 accepted) EHD USE ONLY <br /> FILES (Specific addresses address ranges will not be acce ted <br /> F-1 Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) ®CONSUMER <br /> i 800 W EIGHT MILE RD STOCKTON <br /> Other Cleanup Site(Non-LOP) <br /> Hazardous Waste ❑DAIRY <br /> F�Tiered Permitted Facility 2 900 W - LOWELL AVE TRACY <br /> Aboveground Tank <br /> ❑ <br /> UST (Monitoring/Removal) MOUNTAIN PWS <br /> 3 1090S CENTRAL PKWY <br /> Hazardous Materials HOUSE <br /> ❑Spill/Release Response <br /> WATER QUALITY <br /> F1 Solid Waste Facility/vehicle 4 1405 STONEWOOD AVE MANTECA <br /> Food Facility <br /> ® Pool/Spa ❑SITE MITIGATION <br /> Dairy a 1641 N RIPON RD RIPON <br /> ❑ Land Use Application Sites <br /> E]HouslNc <br /> Septic Pumper Truck/ <br /> s 2725 PAVILION PKWY TRACY <br /> Yard/Chemical Toilets <br /> F1 Wastewater Treatment Plant ❑CUPA <br /> E] Housing Abatement 7 4030 E MORADA LN STOCKTON AST/HM/HW <br /> ❑ Motel/Hotel <br /> ❑Chicken Ranch/Dog Kennel ❑CUPA <br /> �] Medical Waste Facility 8 UST <br /> Tattoo/Body Piercing <br /> SOLID WASTE <br /> Waste Tire 9 <br /> F] Complaint <br /> ❑ Other(Please Specify): ❑Accou NT Nc <br /> 10 <br /> "`'"`BOXED AREA-EHD USE ONLY*** <br /> 10/30/2017-EMAILED APPLICANT TO CONFIRM RECEIPT OF PRRA. DOM M <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: EHD 48-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />