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We I�IqiV ED <br /> SAN JOAQUIN COUNTY UMBER7 1 L E <br /> Nov 19 2016 ENVIRONMENTAL HEALTH DEPARTMENT- <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 ' <br /> ENVIRONMENTAL HEALTH Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Kassandra Pay BUSINESS/AGENCY: Brusca Associates,Inc. <br /> ADDRESS: 1860 Sierra Gardens Drive,#332 CITY/STATE/ZIP: Roseville,CA 95661 <br /> PHONE(1): 916-990-7461 PHONE(2): FAX OR E-MAIL: kpay@bruscaass o <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 /> ❑ CHECK BOX TO EXPEDITE REQUEST-$139 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DA <br /> SIGNATURE OF APPLICANTDATE 11/28/2016 <br /> 1. List up to ten addresses in the space below. Select the e(s)of files from the list below by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax t (209)464-0138 or mail to the address indicated above. Address ' <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted above. <br /> 3. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately to 10) <br /> days after receipt of application. The files will be held for a maximum of five business days for review. Appointme <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$139 deposit prior to review. <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 1900 to 2016 <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> LESEHD USE ONLY <br /> UNDERGROUND TANK(UST) Street# Street Name City <br /> CLEANUP SITE(LOP) Site I jab nu add,Ins but is located ❑CONSUMER <br /> southerly of East Pescadero Avent ie Tracy <br /> OTHER CLEANUP SITE(NON-LOP) zI <br /> J APNS:213-070-74&-084 <br /> t�'F' AZARDOUS WASTE <br /> v ❑DAIRY <br /> TIERED PERMITTED FACILITY <br /> 1535East Pescadero Avenue Tracyv�'� <br /> ABOVEGROUND TANK <br /> Tom'UST (MONITORING/REMOVAL) ❑PWS <br /> HAZARDOUS MATERIALS 1400 East Pescadero Avenue <br /> �,/SPILURELEASE RESPONSE Tracy <br /> `�►/f SOLID WASTE FACILITY/VEHICLE WATER QUALITY <br /> T- 4 <br /> FOOD FACILITY <br /> POOL/SPA EtSITE MITIGATION <br /> DAIRY 5 <br /> LAND USE APPLICATION SITES <br /> SEPTIC PUMPER TRUCK/ ❑HOUSING <br /> 6 <br /> YARD/CHEMICAL TOILETS <br /> WASTEWATER TREATMENT PLANT <br /> CUPA <br /> HOUSING ABATEMENT 7 <br /> MOTELIHOTEL <br /> $(CHICKEN RANCH/DOG KENNEL CUPA-UST <br /> MEDICAL WASTE FACILITY 6 <br /> ITL <br /> n_TATTOO/BODY PIERCING � <br /> WASTE TIRE SOLID WASTE <br /> COMPLAINT <br /> Lj OTHER(PLEASE SPECIFY): C]ACCOUNTING <br /> 10 <br /> ***BOXED AREA-EHD USE ONLY*** <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> EHD 48-06 <br />