Laserfiche WebLink
: 10 2018 11:57AM C5593745 1 1 <br /> me <br /> :. Company kECEIVED <br /> SAN �JOAQUIN J�;� 100 Z0 <br /> 1Environmental Health Department <br /> - C O U N T Y - P BLI,9 RECORDS RELEASE APPLICATION <br /> • Gtentness grows FI ek1VIRQNftI . �3qiqo PERMIT/SE, BY EMAIL 7- <br /> EHD LOG NUMBER. <br /> APPLICANT: Paul Humphrey BUSINESS/AGENCY: <br /> ADDRESS: 7402 E. Clinton Ave CITY/STATEIZIP:Fresno,CA 93737 <br /> PHONE (1): 559 977-9813 PHONE (2). FAX OR E-MAIL: Paul@esahumphrey <br /> Please allow 10 business days from date of application submittal for the retards to be available, <br /> Staff will contact yr';4c'� <br /> arrange an A poi ent date and time to review the requested records. <br /> SIGNATURE OF APPLICANT DATE July 10,2018 <br /> 1- List up to ten addresses in the space below. Add ss rang ILL NOT be accepted. Select the types)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@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. 7/1� <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 6:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List ❑ Map— Description: <br /> Specific Date Range of Information Requested: From AsyLA11 to <br /> ENVIRONMENTAL FILE ADDRESS /'-CC) 1-3 (� <br /> HEALTH DEPARTMENT �, 9 accepted) EHD USE 01 <br /> FILES (Specific addresses on address ranges will not be acce ted <br /> Ox Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) r-, �}J.t� .�[� 94 ❑CONSUMER <br /> Other Cleanup Site(Non-LOP) t N01 Y`�a �"" `^f Ot) Pw' -rr4 47 N SIF. IF <br /> Q Hazardous Waste � n S 1, li ❑DAIRY <br /> QX Tiered Permitted Fealty (((!/ 2 Try mfr I�a �'Sav, ��S I�� 'r/a Gy ,/y� <br /> 7X Aboveground Tank l�'Ir t`✓,{/•/ / , 1 t tl� �ST l W <br /> FX�UST (Monitoring I Removal) ❑pWS <br /> ❑X Hazardous Materials 3 <br /> QX Spill I Release Response <br /> WATER QUALITYFX Solid Waste Facility I Vehicle g © <br /> Food Fadlity <br /> ❑Pool/Spa SITE MITIGAT70N <br /> Dairy 5 <br /> FX Land Use Application Sites <br /> ❑Septic Pumper Truck/ ❑HOUSING <br /> 8 <br /> Yard/Chemical Toilets <br /> ❑Wastewaler Treatment Plant CUPA <br /> ❑Housing Abatement 7 AST/HM/HW <br /> D Motel/Hotel <br /> F Chicken Rench I Dog Kennel ©CUPA <br /> Medical Waste Facility a UST <br /> ❑TattooBody Piercing <br /> ©SOLID WASTE <br /> Waste Tire g <br /> Complaint <br /> Other(Please Specify): ❑ACCOUNTING <br /> 10 <br /> —'BOXED AREA-EHD USE ONLY" <br /> I. I 2 21 19714, = 0 C0000 2- ) <br /> � rn r <br /> provided by Staff-PPR Complete. StatfName: EHD43-0 <br /> Re c e i v e d T i metltJ Li 1, 10. jt:2018;o11 : 50AN%iNo._3847,205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />