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mr"ECEI , <br /> DATE REC.EIVM EHD.LO.G NUMBER <br /> i� SAN.1 QAG2UIN COUNTY <br /> NOV 0 8 2016 LNVIRONMENTAL.HEALTH DEPARTMENT <br /> 1,$68 EastHaaelton Avenue.Stocl fon,CA.95205-6282 <br /> EWRONMENTALiF9F�1..1" 464-0l381Neb:uuww.s}gov.org/ehd: <br /> 6F;J11TAa ?�vrrncm <br /> pnrtSere�IGCS _EASE APPLICATO <br /> APPLICANT: 13 19IN8SWAOENOY; <br /> ADDRESS: $.har!rion1C.astagno C1TY1S'fATEIZIP: <br /> PHONE(1): _ 30251 G01deri Lantr , ' ui #E�© FAX•.OR`E-MAI nS # 5 116 16 W W <br /> La1.guna Nrg.ilel, CA 92577 <br /> rationakmiHal fbr#m records tD[ieavailable, <br /> Tel: 49-9-3564- Fax; 949 429'-3563 daiie grid fine l r +i�,er fhe tegi WSW iecoift <br /> Q GI-Il 8-ha1117t3:,n cr•Envlro'mer`1taiSuppoltSelviCe,S<CorrGl�C4f.QNLY,j'-I�EL2UEST'PROCE5SED IN013 SINE88 Df1YS <br /> SIGNATURE OF APPLICANTDATE.•. JJJ �i <br /> I., List up to ten addresses illiibspace•below. S the type(t)of files,from•the I:istbelow by checking therapk6priate <br /> boz(es) At least pile file typ&MUST Ile selected: Fax X209)484.-013S.or mail td the address:7ndlca'ted:aboVti.. Address <br /> ranges will not lie:aecepted.Applca#igns received after"300 pm will b'e prncesseci the next,business day, <br /> 2;_ FOY assistance rn Fdenfifying the natrare and content of EHD records;please contacf EHD:at the riumbei tliited abov ,. <br /> 3. The E H D will notify the applicant if'any END files exist. An Appointrnetit for reVretrtrwfll be c6nfirrned approximately ten(1.0) <br /> days.after .receipt of application. The files i+vill be held for a maximum of hire business'days fol review: AppointrnQnts- <br /> OzIuld bd scheduled'accordingly. <br /> 4. Ariy file 001 returned in the same conilttron as released will be reo.igan¢ed by Ehib staff.at the ekpen'se of the applican#: <br /> Future .fife reviews-ty thesalYie applicant may rec ui.Ce a:$i39.dep0sif pr or:to revielnr. <br /> VOML AND OPTIC PFRVU REMRDS ARE AVAILABi.E:FCR REVIEN. •M=AY-FRIDAY ,00 AW6.00PM.(EXCLUDING HOWAY5)': <br /> Electronic Infarmatiolrs0 List El Map.—pesc'ription . <br /> )640i Rate F;b*of Flom - J. ipl <br /> ENVIRONMENTAL.. <br /> HEALTFI:DEP,ARTMENT FILE i4DDP,8$$ <br /> FILES EHD USE 'ONLY <br /> fl UNi%FkGaggNR TANK-(WO Street# Street Name City <br /> CLEANup SITE(LO'P} .n l 0:rONSUMER' <br /> OTHEA.CCEA7dFlP SITE JNON-L ../1 p s:.y'� 1 .2F 'TC1G' <br /> [ HAZAIwou's.INasfiE v .0 two <br /> TIERED P"ltrID Fni 2 <br /> [jl�AsovECRo17ND T.a:[aK <br /> USF'(hlON1TOFi1N _]R MOV+IL) 13 RWS <br /> �('rA7_F1ElDOl1S.VATERIALS <br /> 3 <br /> �SPI(;11RELEASE,RESPbNSE <br /> S'fVA`[ER'.QUAtiT.Y <br /> $:G$,ID V.ftTE FAC.IUT(I'VE}11GLE 4 1 <br /> El 5adla FAel ltx l <br /> Poa�isr?n Srskllr.ICAnox <br /> PAIAY 5 <br /> LAND USE AP.PuCATION'SRES.. <br /> 0 SEPTIQ PuMPEt TR q1 4 ..E]NCril,31NCy <br /> 6 <br /> 'YArtU I CFIEMICAI,TOILETS <br /> WASTEWATER TNFATMFNT PLANT c{JPA <br /> h1,OLISIFSG�48ATE141,CNT 7 <br /> (]iNoi�Uk�aTK <br /> _ <br /> CHICKEN'ikmc bbsKENNEL CUPA-U.ST <br /> ❑ME0I91,1L.V1fAS.TE FACIUTY $ <br /> P.IERCING <br /> grWASTE TIRE SbLID YVIS'Ii: <br /> El Cd SPL1ilIJ7 I / <br /> OTHER(P.LEAdE SPEC)FY: _ <br /> n'A�co:IrJrirrc <br /> to <br /> '"`E30X'@D A13EA-EPi1],USEANL.YY°' <br /> ❑.Records'provide:d by:staff-PR.R Gompleie.:statmame: <br />