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3� Fro m:2096296'161 RECEIVED 04/26/20'18 '15:02 #246 R.0011001 <br /> ®■ <br /> 91 <br /> 91? APR 2 6 2018 <br /> 01 SAN �JO A Q U IN Environmental Health Department <br /> ENVIRONMENTALHEALTFPUBLIC RECORDS RELEASE APPLICATION <br /> • — —C O U PJ l --- PERMIT/SERVICES <br /> I SUBMIT BY EMAIL EHD <br /> EHD LOG NUMBER: 10 <br /> APPLICANT: JANNETTE ASSALI BUSINESS/AGENCY:BFT MT HOUSE LLC <br /> ADDRESS: 4866 SALIDA BLVD CITY/STATE/ZIP:SALIDA,CA 95368 <br /> PHONE(1): 209-529-7050 PHONE(2): FAX OR E-MAIL: jassall@ctytower.com <br /> Please allow 10 business d�RARVI <br /> pli ation submittal for the records to be available. <br /> Staff will contact y ratp and time to review the requested records. <br /> SIGNATURE OF APPLICANT DATE 4asne <br /> 1. List up to ten addresses in Oe ace elow. Addre§ ranges WILL NOT be accepted. Select the type(s)of files from the <br /> list below by checking the aWopriate box(es). At least one file type MUST be selected. Fax to 1209)464-0138 mail to the <br /> address indicated below,or email to infogbsicehd.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. J <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From 4/25/2018 to current <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT ( y 9 p ) EHD USE ONLY <br /> FILES Specific addresses oni address ranges will not be acce ted <br /> Underground Tank(UST) Street# Street Name City <br /> Cleanup She(LOP) � Doxws�a <br /> • 1 25456 S Schulte Rd Tracy, CA —cmaLL <br /> Other Cleanup Site(Non-LOP) <br /> H32a,,im.Waste ❑Daae <br /> Tiered PerrNnad Facility 2 \ <br /> E]Abcvegmund Tank Mot, vL'P('11r� I V Nvil <br /> E]UST (Mongodng/Removal) IV ❑PWS <br /> Hazardous Materials <br /> []Spill/Release Response ❑WATsn D.,W <br /> Solid Waste Facility I Vehicle 4 <br /> Food Facility <br /> Pool/Spa ❑sns Mmwnox <br /> 5 <br /> Dairy <br /> Land use Application Sites Hwsixc <br /> Sepgc Pumper Trpck/ a <br /> Yard/Chemical Toilets <br /> ❑wastewater Treatment Plant ❑CUPA <br /> ❑Housing Abatement 7 AST/HMIHW <br /> ❑MoteuHotel <br /> WPP <br /> Chicken Ranch/Dog Kennel UST <br /> 9 <br /> Medical Waste Facility <br /> Tattoo/eody Piercing ❑Sow We <br /> —T Waste Tire 9 <br /> n Complaint <br /> jon��O"tthhte��r(PleaseSpecify):Specify): ❑Accouxnxs <br /> IvssrtluY +t(1,Sp"CA to <br /> �Qp�-- ""BOXED AREA-EHD USE ONLY"' <br /> X- -('WA A Cam "-, rz(z]ak O4 PVA- <br /> 0 Records provided by Staff-PPR Complete. sae Hama: EHo wus <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br /> Received Time Apr. 26. 2018 2:34PM No. 3437 <br />