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,- rrloay, uctooer UV, 2UlU 12:b1 NM . Jodi Vanneman 415-479-3988 P,01 <br />m®9 <br />Ell Mg <br />rs is <br />la <br />"i11 EHD LOO NUM5ER <br />11 FEE IWED SAN JOAQUIN COUNTY <br />'y OCT 9 2015 ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenua, Stocklon, CA 95205-6232 <br />Talephena: (209)A6P.U20 Fix: (209)J6d.0138 Weh: (nnA".v.sJgay.orgldhB <br />ENVIRONMENTALPERMI/SERVHEALTN PUBLIC RECORDS RELEASE APPLICATION <br />PERMIT/SERVICES <br />f-= <br />APPLICANT: Jodi Vanneman SUSINESSIAGENCY: EBI Consulting <br />ADDRESS: 829 Tamarack Drive CITYI5TATE01p: San Rafael, CA 94903 <br />pt QNg(1); 415-342-5144 PKONE(2): FACSIMILE: lvannemaniumshcglohal.net <br />please allow 10 business days front date of applicirdon submittal for the records to be svallsbfe. <br />Staff will contact you to arrange an appointment date and time to raylew the requested records. <br />❑ CHECK BOX TO EXPEDITE REQUEST -SIX FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 SUSIN€SS DAYS <br />SIGNATURE 6F APPLICANT `"„' MATE 10/09/2015 <br />Electronic Information: ❑ List El Map — Otscriptlon: <br />FILE ADDRESS <br />END USE ONLY <br />❑ Urn I <br />Street IF suset Name City <br />1. 75 West Val Ico Road Trac <br />`' "p--cot«V'- <br />Unit2 <br />2.17 <br />a. <br />�ro4jel 3411e <br />4. <br />6. <br />t74�W1 <br />7. <br />Unn s <br />fS.El <br />e. <br />SIf� R�lfiS° <br />trnn-t:- <br />40. <br />SD4tl0c Dete Range al Iniotmanon RMu6itetl; Pont t0 <br />ENVIRONMENTAL HEALTH OrPARTMEWTFILES <br />UNDencAoUNDTANR(UST)CLEAimPSMILOP) MD'.LALbWAstEFAGLrTY 54:my6forcrA6Eitr,'VENKLE <br />I OTRERCLIMUPWE(No"015) HNousmASAIEWNT WASMTRE <br />UNDERBRWROTANK (rAONncRelyltFLOlAlJ rOoo FACILITY DAIRY <br />L� ABovECRwilD TANK BCwux RmcW Doo KENNEL INMTEwATERTEEATum PLANT <br />❑ HA2Amom WASTEMnAr=s hIATERWS ❑ MOTEUH0IEL PusPERTictKARDICHEm a TDLETa <br />eTIRED PERtI11110 FACILM1500USPA LAND USEAPPLiCArm SITES <br />TATIDO2500YPCRCwG ❑ COuPLANTIR96004SERECORDS OMR (PLEASE S PSMI, <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MM12AY•FR IOAY 8:00 A:A14:00PW CDCLUMNG HOLIDAYS) <br />Y. List u0 to ten addresses In file spaCe Sb0VR. Select the Typo(s) of fires from the list above by Checking the appropriate <br />boxles). At least one file type MUST be ieleaed. FaR to f20`}t 46401$ or m it tp the address Ind catsd apor . Addrts3 <br />ranges will not be accepted. A.ppllC01:10ss reC6lYed after 3:00 pm will be processed the Dext business day. <br />2. r'or as encs In identrfying the nature and content of EHD reeofds, please contact EHD at the number noted above. <br />a. The EHO will notify the applicant if any EHO filet exlsL An appdrrltntent Yon review "Il be conn med approximately ten (te) <br />days after recelpt of application. The hies will be hold for a maximum of five business days for Trrvlew. Appointments <br />should be scheduled acoordtngly. <br />4. Any file not retUmee In Int some cottdluCn as released Witt be reorgantsed by riHD stat! 411 the expense of the aw("Mt. <br />Future his reviews by the same appll"rit May squire a $In deposit priorto review, '•'&OXFD AREA • EFID USE ONLY”' <br />. tUll Name: <br />Received Time Oct, 9, 2015 12:53PM No.9744 <br />