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SAN AM - J;;L 23 2018 Environmen, Health Department <br /> — COUNT Y-- PUBLIC RECORDS RELEASE APPLICATION <br /> c::,ess gr ,.:. F,E.WRIONM 0411 (12, <br /> PEt'<fcIV B„ EMAIL <br /> EHD LOG NUMBER: <br /> APPLICANT: Jessica Oxford BUSINESS/AGENCY:Nova consulting Group,Inc. <br /> ADDRESS: 5114 West Jay Bend Lane,Apt.S208 CITYISTATE/ZIP:Hammon,UT 84095 <br /> PHONE(1): 801.358.6912 PHONE(2): FAX OR E-MAIL: 952.448.9572 <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 9__`p1r DATE 712312018 <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(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. - <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: ❑x List N Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT <br /> FILES (Specific addresses only,address ranges will not be accepted) EHD USE ONLY <br /> QX Underground Tank(USTI Street# Street Name City �,y1 <br /> Cleanup Site(LOP) til i -T [ Goasuinse <br /> Q Other Cleanup Site(Non-LOP) 1 835 WEST HARNEY LANE LODI <br /> Q Hazardous Waste n,t DMm <br /> Q Tiered Permitted Facility 2 1516 SYLVAN WAY LO D I r <br /> lXJ Aboveground Tank p <br /> FX UST (Monitoring/Removal) P6 ❑PwS <br /> Q Hazardous Materiels a 1718 SYLVAN WAY LOD <br /> Q Spill/Release Response <br /> �S ATER auAum <br /> Q Solid Waste Facility/Vehicle 4 <br /> R Food Facility i Iry <br /> Q Pool/Spa �`n Sire MiTicnnory <br /> F1 Dalry 5 tl 7 <br /> Q Land Use Application Sites <br /> Q Septic Pumper Truck/ s ® ouSiNe <br /> Yard/Chemical Toilets <br /> Q Wastewater Treatment Plant fl CUPA <br /> Q Housing Abatement 7 AST)HM IHW <br /> R Motel/Hotel <br /> ❑Chicken Ranch/Dog Kennel uPA <br /> 8 <br /> Medical Waste Facility UST <br /> TattoolBody Piercing Sou."I <br /> Waste Tire g <br /> Complaint <br /> Other(Please Specify): ❑Acccuonec <br /> 10 <br /> ***BOXED AREA-EHD USE ONLY*** <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: EHD 48-08 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sicehd.com <br />