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i <br />SAN JOAQCEIVED� Environmental Health Department <br />- COUNTY PR 1 8 2018 uy� PUBLIC RECORDS RELEASE APPLICATION <br />Great Elill G5,3 <br />nrnr H. IT BY EMAIL <br />APPLICANT: KEVIN JOHNSTON <br />ADDRESS: 2288 BUENA VISTA AVENUE <br />BUSINESS/AGENCY: <br />CITY/STATE/ZIP: LIVERMORE CA 94550 <br />PHONE (1): 9254475200 PHONE (2): FAX OR E-MAIL: CAT416CIT@GMAIL.COM <br />Please allow 10 business days from date of application submittal for the records to be available. <br />Staff will contact you to ar n �ppcilfiffnent dateand time to review the requested records. <br />SIGNATURE OF APPLICANT DATE 4-13-18 <br />1. List up to ten addresses in th ace below dress 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(cDsicehd.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. Ll /-7 <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 ALL to PRESENT <br />ENVIRONMENTAL <br />FILE ADDRESS <br />HEALTH DEPARTMENT <br />FILES <br />`5 <br />Specific addresses <br />only, address ranges will not <br />be accepted) <br />H D USE ONLY <br />Q Underground Tank (UST) <br />Street # <br />Street Name <br />city <br />1 <br />25485 <br />N <br />ST RT 4 HY <br />FARMINGTON <br />CONSUMER <br />Cleanup Site (LOP)*6 (LOP)* <br />Other Cleanup Site (Non -LOP) <br />Xrt++'�'� <br />Hazardous Waste <br />IaWIHVv�(>,S'� RV <br />j WJ DAiN <br />Q Tiered Permitted Facility <br />2 <br />4469 <br />E ESCALON BELLOTA RD <br />F R INGTON <br />S5 157V -(T -A C_ <br />Q Aboveground Tank <br />Q 1137 (Monitoring /Remova0ST <br />a <br />17000 <br />RT 120 HY <br />_ <br />R`IPON <br />S <br />i <br />❑X Hazardous Materials <br />NM 1AW Wik N'CA <br />nX Spill / Release Response <br />Q Solid Waste Facility / Vehicle <br />4 <br />16636 <br />E ST RT 120 HY <br />;.y t <br />RIPON <br />Aran uulry <br />xl Food Facility <br />X Pool / Spa <br />° <br />RIPON <br />5 <br />16996 <br />�E ST RT 120 <br />Srta MmonnoN <br />Q Dairy <br />Q Land Use Application Sites <br />5"lyJ't'1 I� 11 / I �.OnW <br />t 1 SING <br />`1r�t/_s_c <br />Q Septic Pumper Truck/ <br />6 <br />21801 <br />E ST RD 120 HY <br />ESCALON <br />By f %1(:C+ <br />Yard / Chemical Toilets <br />LS <br />— % + <br />7950 <br />I — <br />S VAN ALLEN RD <br />�1 <br />ESCALON <br />COPA <br />AST I HM IHW <br />Q Wastewater Treatment Plant <br />Q Housing Abatement <br />Q Motel/Hotel' <br />CUPA <br />❑X Dog net <br />g <br />1851 <br />VALPICO ROAD <br />TRACY <br />UST <br />Medical Facility <br />Q Metlical Waste Facility <br />❑X Tattoo/Body Piercing <br />SGLIG wASTE <br />❑X Waste Tire <br />9 <br />17357S <br />MURPHY RD <br />RIPON <br />Q Complaint <br />10 <br />17428 <br />S NORTH RIPON RD <br />RIPON <br />❑ AccauN*wG <br />�. Other (Please Specify): <br />4- M45�1 <br />SP \­t'C <br />***BOXED AREA-EHD USE ONLY"* <br />❑ Records provided by Staff -PPR <br />1868 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />1 PC <br />