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RECEIVED <br />SAN 1OAOUINJUL 10 2018 Environmental Health Department <br />C 0 U N T YENVIRONNIENTAL HEALTH PUBLl RECORDS RELEASE APPLICATION <br />• PERMIPSERV ff BY EMAIL ?41l Y 3 <br />EHD LOG NUMBER: <br />11 <br />APPLICANT: Paul Studemeister BUSINESSIAGENCY: LEE Inc. <br />ADDRESS: 28 Geary Street, Suite 525 CITY/STATEIZIP: San Francisco. CA94108 <br />PHONE (1): 415-421-2758 PHONE (2): 6501 " 1 =++ FAX OR E-MAIL: ustudemeister@leei.com <br />Please allow 10 business days from date of application submittal for the records to be available. <br />Staff will contact you to�ra e a " po ent date and time to review the requested re rds. <br />SIGNATURE OF APPLICANT ( DATE Qr <br />1. List up to ten addresses in the space below. Address ranges WILL NOT be accepted. Select the type(sj 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 infogsicehd.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•5:00PM (EXCLUDING HOLIDAYS) <br />Electronic Information: Z List x❑ Map — Description: A:'v cleat- nnatc;. be u-e�u! a a 1 <br />Specific Date Range of Information Requested: From 2,%i to <br />ENVIRONMENTAL <br />FILE ADDRESS <br />1" L� 10 <br />HEALTH DEPARTMENT <br />FILES <br />(Specific addresses <br />9 <br />only,address ranges will not <br />be accepted) <br />p <br />EHD USE ONLY <br />Underground Tank (UST) <br />Street # <br />Street Name <br />City <br />1 <br />9000 <br />�/�� <br />Y Y . Vernalis Rd. <br />Tracy <br />1' `w ❑ coNsu R <br />j <br />F} V`' �St� SINN❑ <br />Cleanup Site (LOP) <br />Other Cleanup Site (Non -L ) <br />Hazardous Waste <br />f I <br />DAIRY <br />❑ Tiered Permitted Facility <br />2 <br />_ <br />(1M �!V N� ( l�11 L) <br />MX Aboveground Tank <br />❑ PWS <br />1x UST (Monitoring /Removal) <br />XQ Hazardous Materials <br />3 <br />Ix Spill 1 Release Response <br />❑ WATER DUALIT <br />Solid Waste Facility / Vehicle <br />4 <br />i <br />❑ Food Facility <br />❑ SITE MITIGATION <br />Pool / Spa <br />Dairy <br />5 <br />Land Use Application Sites <br />a <br />❑ HGUSIlIG <br />Septic Pumper Truck t <br />Yard I Chemical Toilets <br />Cg UPA <br />El Wastewater Treatment Plant <br />n Housing Abatement <br />r <br />AST I HM I HW <br />171 Motet/Hotel <br />COPA. <br />❑ Chicken Ranch I Dog Kennel <br />Medical Waste Facility <br />a <br />UST <br />Tattoo/Body Piercing <br />❑ SOLID WASTE <br />Waste Tire <br />e <br />1] Complaint <br />�o <br />❑ ACCOUhTING <br />El Other (Please Specify): <br />—BOXED AREA - EHD USE ONLY"" <br />-CC - 4,.- h\ , Ln�o r f!< A , D Ca wv? �V'vz. rile <br />❑ Records provided by Staff -PPR Compl te. Staff Name:aQl2(1!4—PrWd0dEHD 48-06 <br />• 1868 E. Hazelton Avenue I Stockton. California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />