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jo: San ioaquincounty cnvironmeni:ai i­-,ageW_ IV, IV,: :U'� (UIVI 1) t-rom: mimr)eriey ir-iumme <br /> 4epa rurn emn't <br /> -c n u- <br /> $14 U r-ronrorim -l"EMMZU <br /> PUBLIC REcOIM6 RELEASE APPLICATION <br /> "o. <br /> -MAL <br /> EWROMEKTALI <br /> PERuirr/gEMCES EHD L0_G NUMBER:* <br /> X BUSINESsIAGENCY" <br /> D' <br /> U7. S <br /> cm <br /> APPLICANT: <br /> ADDRESS. P1. ITYISTATE2 " . srtdr erg__ ? <br /> PHONE(1); or. recrn <br /> Please allow 10 business daySTIMM date ofapplicatlall submittal <br /> Staff will c0h%CtyQWjW4n, an <br /> SIGNATURE OF APPLICANT —V`_ <br /> 1. List up to tart es in thfiddress below. Atype MUST be selecte €2091 a64-0738 mail +�o d.list below.by checking the appropriate box(es). At least one filethe addindicated.res- below,or email to i gii�� Applications,received after 3,00 pm Witt be Processed the next <br /> business day. E D at 9 number noted below. <br /> 2. For assistance.nce in identifying the nature and content of EHO records,please.contact H th <br /> 3. The EHD will notify the applicant if any EHD files exist. An appointment far review will-be confirmed approximately ten 10 <br /> days after receipt of application, The files will bia.held for a maximum of fivii business days for review. ApPointments <br /> should The scheduled accordingly. nse of the applicant. <br /> 4. Any file not returned In the same condition as released will be reorganized by EHD staff atthO expe <br /> Future file reviews by the same.applicant may require a'$152 deposit prior to review. 10/11 <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REvIEW: MONDAY-FRIDAY 9:00 AM-5.00PM(EXCLUDING HOLIDAYS) <br /> LF-lectronic,Information' 7j'List F_1M_aP—t)S <br /> Specific Date Range of information Requested* FTOM to <br /> ENVIRONMENTAL <br /> FILE AD-DRESS <br /> HEALTH DEPARTMENT (specific addresses only,address ranges will notbeaccepted) EHD USE ONLY <br /> FILES <br /> onderpround Streett 0 Street Name city <br /> 01 Sr"e(LOP) <br /> eOth ­" <br /> 0 DA.Ry <br /> Ste <br /> (Non-LOP <br /> Gl Hazardous waste I f / <br /> 7 <br /> 1� 2 /7 1 <br /> l" Ti .ed Pennifed Facirty <br /> Aboveground Tank i PWS <br /> F-1 <br /> UST (Monitoring I Removal) <br /> Hazardous Poaterials <br /> VMTER QU�V`y <br /> E]s.01.1 Release Response <br /> S,01.icl Waste Facility f vetlicie 4 -7 <br /> 19 <br /> Ej Fwd Facility s-m MrrieAnoN <br /> r <br /> Pool./spa <br /> LD.'6y Use Application sites l l 0 ticnis)t4G <br /> Septic Pumper Truck <br /> cat Toilets GQPA <br /> Yard!Chemical <br /> F-1w,15,tei&wer Treatment Plant iAST1t19fHW <br /> Housing,Abatementtt 7 <br /> kro.teilHotel <br /> CUPA <br /> Chicken Ranch I Dog Kermel 8 t UST <br /> Nledical Waste Facility ti(SOLID wwm <br /> -4-rattoolBody Pie.rciog <br /> �-'Va.ste Tire i a <br /> Complaint.. <br /> �y 0 Accouuri%,s <br /> Ozher(?lease Specify): <br /> " ..BOXED AREA-EHD USE ONLY <br /> Jan Ire gge <br /> 0 Records provided by Staff-PPR Complete. Staff Name: EHD 48-06 <br /> Received Time Oct. 2. 2017 4: 56PM No- 2382 <br />