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DAI21"EXENEe SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> �uiJ U 9 2(f97 l0 <br /> Po ENVIRONMENTAL HEALTH DEPARTMENT �r��//�♦//�2 [/T.✓O <br /> ' <br /> 1:(2 East Haz'8-3420 F Avenue, Stockton, CA b:ww sigov.org/ehd <br /> ENVIRONMENTAL H Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> . PERMIT/ ER10rcFclm PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Hillary Prince BUSINESS/AGENCY: ERM -Sacramento <br /> ADDRESS: 2525 Natomas Park Drive,#350 CITY/STATE/ZIP: Sacramento,CA 95833 <br /> PHONE(1): ��9-7�0�70 PHONE(2): NA FAX OR E-MAIL: hillary.prince@erm.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 /> ❑ CHECK BOX TO EXPEDITE REQUEST-$139 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT s�r.�l�i �JZN„o DATE 5/31/2017 <br /> 1. List up to ten addresses in the spaceAelow. Select the type(s)of files from the list below by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464.0138 or mail to the address indicated above Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted above. <br /> 3. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten If 0) <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$139 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 1940 to present <br /> ENVIRONMENTAL - <br /> HEALTH DEPARTMENT FILE ADDRESS EHD USE ONLY <br /> FILES <br /> UNDERGROUND TANK(UST) Street# Street Name City <br /> CLEANUP SITE(LOP) rA CONBUMEa <br /> ®OTHER CLEANUP SITE(NON-LOP , 1 + n / <br /> HAZARDOUS WASTE 619 Gillis Avenue Stockton •f 11 Y` <br /> NRV <br /> TIERED PERMITTED FACILITY ] <br /> ®ABOVEGROUND TANK <br /> ®UST (MONITORING/REMOVAL) Ej PWS <br /> O HAZARDOUS MATERWLS 3 <br /> ®SPILURELEASE RESPONSE <br /> ®SOLID WASTE FACILITY/VEHICLE 4 ATER QUALITY <br /> XI FOOD FACILITY <br /> ©POOL/SPA <br /> O DAIRY 5 �P{ MITE MITIGATOR <br /> ©LAND USE APPLICATION SITdES <br /> ©SEPTIC PUMPER TRUCK/ Y UUV(i 1 OUSIHG <br /> 6 <br /> YARD/CHEMICAL TOILETS <br /> ®WASTEWATER TREATMENT PLANT <br /> O HOUSINGABATEMENT r 11CUPA <br /> O MOTELIHOTEL <br /> ®CHICKEN RANCH/DOG KENNEL �.CGPA-UST <br /> ®MEDICAL WASTE FACILITY 6 <br /> ®TATTOO(BODY PIERCING <br /> ©WASTE TIRE OLID WASTE <br /> ®COMPLAINT B <br /> ❑OTHER(PLEASE SPECIFY): <br /> 10 A20UNTING <br /> —BOXED AREA-EHD USE ONLY— <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> EHD 48-06 <br />