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Rtt+tlVtu <br /> SAN J O A Q U I N MAY 0 3 2018 Environmental Health Department <br /> — —C GU N T Y--ENVIRONMENTAL HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> • <br /> PERMIT/S__1____ 0r,7yr SUB BY EMAIL DJ <br /> EHD LOG NUMBER: <br /> APPLICANT: Trey Whitehead BUSINESS/AGENCY:Nova Consulting <br /> ADDRESS: 1107 Hazletlne Blvd CITY/STATE/ZIP:Chaska,MIN 55318 <br /> PHONE(1): (510)388-7845 PHONE(2): FAX OR E-MAIL: Lbey13@gmail.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 i G/.fitavf<.ad DATE May 3.2078 <br /> 1. List up to ten addresses in the spac6 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(2 9)464-0138, mail to the <br /> address indicated below,or email to infoicDsicehd.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! <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 to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT ( ponly, 9 p <br /> FILES S ecifc addresses address ranges will not be accepted) EHD USE ONLY <br /> Q Underground Tank(UST) Street# Street Name city <br /> Cleanup Site(LOP) 'n Ip[ O CorvsUMEP <br /> Q Other Cleanup Site(Non-LOP) <br /> 1313 Eor Manin Luthee King Blvd lo,E Charter Way) Stockton- <br /> RX Hazardous Waste 0 DaDe <br /> El Tiered Permitted Facility 2 II,, <br /> 2Aboveground Tank (l T LL_ LOP <br /> ❑X UST (Monitoring/Removal) ❑PWS <br /> nX Hazardous Materials 3 <br /> Q Spill/Release Response <br /> Q Solid Waste Facility/Vehicle 4 TER OUALIY <br /> F]Food Facility <br /> ❑Pool I SpaF 1eS I,E MMGAi ON <br /> Dairy 5 <br /> Land Use Application Sites <br /> ❑Septic Pumper Truck I6 El HOUENNG <br /> Yard/Chemical Toilets <br /> ❑Wastewater Treatment Plant BUPA <br /> Housing Abatement 7 AST/HM IHW <br /> ❑MotellHotel <br /> ❑Chicken Ranch/Dog Kennel COPA <br /> ❑Medical Waste Facility a UST <br /> Tattoo/Bedy Piercing <br /> ❑Souo WAerE <br /> Waste Tire 9 <br /> nX Complaint <br /> ❑Other(Please Specify): ❑AcccoWING <br /> 10 <br /> .."BOXED AREA <br /> f-EHD USE ONLY*** <br /> • 5-3-03 e M n lfr-K reCC AP.eQry `-ht,7fM O Le— 4V2 v"\ <br /> 0 Records provided by Staff-PPR Complete. Staff Name: BHo aeras <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209464-0138 1 wvdw.sjcehd.com <br />