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RECEIVE-Q <br /> SAN J O A Q U In ironmental Health Department <br /> v' uC CJ U TY OC 9 20V PUBLIC RECORDS RELEASE APPLICATION <br /> q<t `' Gre{iir;� i yrur5 cr;- ENVIRON-TALWALTH 87447 <br /> PEMMITI9EMC*'8 EHD LOG NUMBER. <br /> APPLICANT: BRITTANY FOLLETT BUSINESS/AGENCY: TRILEAF <br /> ADDRESS: 1051 WINDERLEY PL, STE 201 CITYISTATE1ZiP: MAITLAND, FL 32751 <br /> PHONE (1): 407-660-7840 PHONE (2): 407-660-7394 FAX OR E-MAIL: B-FOLLETTi@TRILEAF.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 31, 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 infoia,?-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) C1 <br /> Electronic information: ❑ List ❑ Map— Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT ( p Y 9 accepted) EHD USE ONLY <br /> FILES (Specific addresses aril address ran es will not be acce ted <br /> ® Underground Tank(UST) Street# Street Name city <br /> ® <br /> Cleanup Site(LOP) 1 29 N AURORA ST STOCKTON CONSUMER <br /> 1 yy <br /> Other Cleanup Site(Non-LOP)S lCA <br /> Hazardous Waste ❑DAIRY <br /> ®Tiered Permitted Facility 2 33 N AURORA ST STOCKTON [vj� <br /> ®Aboveground Tank f <br /> ®UST (Monitoring 1 Removal) �]PWS <br /> ®Hazardous Materials 3 <br /> ®Spill I Release Response <br /> I@ WATER t7unurr <br /> F1 Solid Waste Facility I Vehicle 4 <br /> ® Food Facility <br /> [� Pool 1 Spa ®SITE MITIGATION <br /> Q Dairy 5 <br /> Land Use Application Sites - <br /> l]HOUSfNG <br /> Septic Pumper Truck 1 6 <br /> Yard 1 Chemical Toilets <br /> ❑Wastewater Treatment Plant ❑CUPA <br /> Housing Abatement 7 AST f HM 1 HW <br /> �] Motel/Hotel <br /> Chicken Ranch 1 Dog Kennel ®CUPA <br /> 8 UST <br /> ❑ Medical Waste Facility <br /> Tattoo/Body Piercing ❑SorID WASTE <br /> ©Waste Tire g <br /> Z Complaint <br /> Other(Please Specify): ❑ACCOUNTING <br /> 10 <br /> —BOXED AREA-EHD USE ONLY*** <br /> 013112D17—EMAILED APPLICANT TO CONFIRM RECEIPT OF PRRA. DOM M <br /> © Records provided by Staff-PPR Complete. Staff Name: EHD 46-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209464-0138 1 www.sjcehd.com <br />