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RECEIVED <br /> SMIOAQUINAW 01 2018 Environmental Health Department <br /> —COU NJ TY--- PUBLIC RECORDS RELEASE APPLICATION <br /> t F.N Pilrif F.NitAL /�ar�/ �] <br /> • p�R� IT BY EMAIL A� `/\(/� <br /> �"Z EHD LOG NUMBER: LJ ` <br /> APPLICANT: duaineapir BUSINESSIAGENCY:Tnlee Eep ronmemal <br /> ADDRESS: 2121 West Chander scrol m.Suite toe CITYISTATE/ZIP:Chandler,Az k6att <br /> PHONE(1): aeoaw-ons PHONE(2): FAX OR E-MAIL: I.bauer®mlaar.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 Justin Bauer - ------- DATE <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 12091464-0138,mail to the <br /> address indicated below,or email to infogipsicelfid.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. F� <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) / 1 <br /> Electronic Information: 0 List Ex Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS l <br /> HEALTH DEPARTMENT (Specific ry, Rangesp ) EHD USE ON Y <br /> FILES 5 ecific atltlresses on atldrDDR will not be acre tetl <br /> 0 Underymund Tank(UST) Street N Street Name city p <br /> Cleanup Site(LOP) NM,br-. ) ?r's ❑Gx+wuw <br /> Q Other Cleanup She(lkhol ) ' 1950 West Fremont Stockton "i'll +gym <br /> • o Retool Woolr�eLyY <br /> Q Tiered Permitted Facility 9 2010 West Fremont Stockton ZVI <br /> px Ahouegmupe Tank <br /> 0x UST (MonhoMB l Rempvap ❑Fw5 <br /> 0X Hesakoes Materials a <br /> nx Spill/Release Response Witten Ol <br /> px Solid Waste Facility)vehicle < <br /> ❑Food Facility <br /> ❑Pool I Spa m Mmrs¶OX <br /> ❑Dalry a <br /> Q% Land Use AppliW4on Site. <br /> Sephc Pumpm Track I p RwaWp <br /> Yard I Chemical Toilets <br /> Wmhaesner TreaMent Plant UPA <br /> Housing Abatement T AST/lost <br /> F1 MetaMmel <br /> ❑Chicken Ranch I Dog Kennel UPA <br /> Medical Waste Facility 9 UST <br /> Temporal Ple'cing larl W.1srs <br /> Wage Tire 9 <br /> nX Complaint <br /> Other(Please Specify): ❑Aummuc <br /> 1g <br /> —BOXED AREA-EHD USE 011 <br /> • -I E <br /> 3 1 R, 5 L q e 29 50 = <br /> X 1,311d — coC <br /> ❑ Oecords provided by Staff-PPR Complete. Staa Mame: 46 sxoaeoe <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />