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APPLICANT: <br />ADDRESS: <br />SQN.)OQQUI! RECEIVEgonmen', Health Department <br />COUNTY— A1C • 30 2(n7 PUBLIC RECt RDS RELEASE APPLICATION <br />Gf,?Otness 'qro Y,s her- 87435 <br />EddVIRlJNMEt�IXALHfEdtLfii EHD LOG NUMBER: <br />e4�'BT' <br />ANNE DUMA <br />5975 SHILOH RD. STE 114 <br />BUSINESS/AGENCY: PK DATA INC <br />CITY/STATE/ZIP: ALPHARETTA <br />PHONE (1): 770-931-9677 PHONE (2): 678-640-0129 FAX OR E-MAIL: COMMERCIALPOOLSraPKDATA.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 infolasicehd.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 <br />FILE ADDRESS <br />HEALTH DEPARTMENT <br />FILES <br />(Specific addresses <br />only, address ranges will not <br />be accepted) <br />EHD USE ONLY <br />❑ Underground Tank (UST) <br />Street # <br />Street Name <br />City <br />® CONSUMER <br />Cleanup Site (LOP) <br />Other Cleanup Site (Non -LOP) <br />600 W <br />EIGHT MILE RD <br />STOCKTON <br />I ,, <br />'❑ Hazardous Waste <br />+ I (� j/f _ DAIRY <br />❑ Tiered Permitted Facility <br />2 <br />900 W - <br />LOWELL AVE <br />TRACY <br />i <br />Aboveground Tank <br />MOUNTAIN <br />[3 PWS <br />❑ UST (Monitoring / Removal) <br />L] Hazardous Materials <br />a <br />1090 S <br />CENTRAL PKWY <br />HOUSE <br />❑ Spill / Release Response <br />WATER quAurr <br />❑ Solid Waste Facility / Vehicle <br />4 <br />1405 <br />STONEWOOD AVE <br />MANTECA <br />❑ Food Facility <br />E] SITE MITIGATION <br />® Pool I Spa <br />❑ Dairy <br />5 <br />1641 N <br />RIPON RD <br />RIPON <br />❑ Land Use Application Sites <br />a <br />2725 <br />PAVILION PKWY <br />TRACY <br />❑ HOUSING <br />❑ Septic Pumper Truck / <br />Yard / Chemical Toilets <br />❑ Wastewater Treatment Plant <br />❑. CUPA <br />❑ Housing Abatement <br />7 <br />4030 E <br />MORADA LN <br />STOCKTON <br />AST/HM1HW <br />❑ Motel/Hotel <br />❑ CUPA <br />Chicken Ranch / Dog Kennel <br />❑ Medical Waste Facility <br />a <br />LET <br />❑ TattoofBody Piercing <br />E] Souo WASTE <br />F1 Waste Tire <br />e <br />❑ Complaint <br />❑ AcGOUNTING <br />❑ Other (Please Specify): <br />to <br />***BOXED AREA - EHD USE ONLY*** <br />10/30/2017 - EMAILED APPLICANT TO CONFIRM RECEIPT OF PRRA. DOM M 11 <br />1) ❑ Records provided by Staff -PPR Complete. Staff Name: EHDM-06 11 <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />