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From: Erik Brown Fax:(8^08)82^0-2635 y To: 12094640138@rcfax.cc Fax: (209)464-0138 Page 2 of 2 01/04/2019 8:21 AM <br /> RECEIV <br /> i.ifDvi_onme1sztal 1l-'� fth De ,a rfm ��s`�^ <br /> ;� , ,. i - ° RELEASE as <br /> ;.� k -.. _ PUBLIC RECORD <br /> .SAN 0 4 2018 uuXA U E�I��I ICA rlanl <br /> ENVIRONMEN36#MM EHD LOG IVUMISER: 7 7%" <br /> A%e=�L€c�lvr: 4� I ,_ (SERVICES BUSINESSIAGENCY: <br /> ADDRESS; y <br /> 1 OITYISTATEIZIP:�, <br /> PHONE : _ — -- a <br /> ( 9 "°- PHONE (2):���� �c��' � ��-� FAX OR E-(MAIL: �? � <br /> Please allow 10 business days from da•6 of application subWi tal for the records to be available. <br /> Staff will contact you to arra�� 0oln t date,and time to reviewthe requested records, <br /> SIGNATURE OF APPLICANT �. � " [}ATE � <br /> � <br /> 1. List unto taro addresses in the space °',ddre s es WILL P40T be accepted. Select the type(s of files horn flue <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 infonasicehd corn 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 bagginess 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 $152 deposit prior to review. <br /> WELL ARID SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List Q.Map—Description: <br /> Specific Date Range o€information Requested: From to <br /> ENVIRON I+flENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES (Specific addresses only:address ranges will not be accepted) HD USE ONLY <br /> Underground Tank(UST) Street# I _Street Name <br /> CK,Cleamp Site(LOP)Other Cleanup <br /> Cleanup AO <br /> Site(1\1nn-LOP) �L:. d, fir P I ❑Consur.��N <br /> iHazardous Waste I !b, <br /> LxTiered Permitted Faciliq 2 tg tp° r' ❑DAIRY <br /> ¢d <br /> Aboveground Tank t 2 t •`: 'Y 0`.rt[�,1 a,: t'e �, `3y" <br /> RUST (Monitoring/Removal) E]PWS <br /> Hazardous MaterialsIt <br /> IQ- <br /> -Spill/Release Response 1 <br /> El Solid Wasie Facilil]y/Vehicle 4 W�T¢n Cua-Iry <br /> Food Facility <br /> El Pool i Spa <br /> E]Dairy 5 ®SRI=hlmcAlION <br /> Land Use Application Sits$ IA N m u a Lt <br /> Septic Pumper Truck/El <br /> ✓ K HouslNc <br /> 6 <br /> Yard/Chemical Toilets <br /> E]Wastewater Treatment Plant <br /> Housing Abatement 7 L`7 CUPA <br /> Motel/Hotel <br /> AST/HM/HW <br /> Chicken Ranch/Deg Kennel <br /> El I;Aedlcal Waste Facility g UFA <br /> Tattoar6ody Piercing UST <br /> Waste Tire Q SOLID wAsre <br /> [I Complaint <br /> I Other(Please Specify): <br /> 1a A:couNTINC <br /> k"iUVXED AREA EI I!J USE®NL I­�' <br /> ® Records provided by StafF-PPI@ C®mplete, staf�nrame: <br /> (� <br /> 1868 E. Htazeiton Avenue j Stockton, c0alifornia 95205 j 'r 209 468-3420 1 F 209 464-0vi38i <br /> — <br /> —Received Tiiii e_Jan. 4. 2018 8: 15AM No, 2817 <br />