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S A NJ O A Q U I N RECEIVWVironmental Health Department <br /> AUG2 8 2017 <br /> _ COUNTY— PUBLIC RECORDS RELEASE APPLICATION <br /> G-eatness q�aws hers. ENVIRONMENTAL HEALTH 8��1V� <br /> PERMITIS RI&Ee EHD LOG NUMBER: <br /> ✓APPLICANT: SANDRA HUANG BUSINESS/AGENCY: ALAMEDA COUNTY PUBLIC HEALTH <br /> ADDRESS: 1000 BROADWAY, STE 500 CITYISTATEIZIP: OAKLAND, CA 94607 <br /> PHONE(1): 510-267-3250 PHONE(2): 510-273-3744 FAX OR E-MAIL: ACUTECD(a)ACGOV.ORG <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 PROCESSED VIA FAX BY STAFF. DOM M DATE August 28, 2017 <br /> 1. List up to ten addresses in the space 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 (209)464-0138, mail to the <br /> address indicated below, or email to info s'cehd.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 EMD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$152 deposit prior to review. V6 <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 (Specific addresses only, address ranges will not be accepted) EHD USE ONLY <br /> FILES <br /> Underground Tank(UST) Street# Street Name City <br /> I/� <br /> Cleanup Site(LOP) 1 3{180 NAGLEE RD TRACY 1 �� 1 M CONSUMER <br /> Other Cleanup Site(Non-LOP) <br /> Hazardous Waste ❑DAIRY <br /> Tiered Permitted Facility 2 3 Col'l�ptalYL'� <br /> Aboveground Tank <br /> ❑UST (Monitoring!Removal) ❑PWS <br /> 3 <br /> Hazardous Materials <br /> Spill!Release Response ❑WATER QUALITY <br /> ❑ Solid Waste Facility 1 Vehicle 4 <br /> [D Food Facility <br /> Pool!Spa ❑SITE MITIGATIDN <br /> F-1Dairy 5 <br /> ❑Land Use Application STtes <br /> ❑HOUSING <br /> ❑Septic Pumper Track! s <br /> Yard/Chemical Toilets <br /> n Wastewater Treatment Plant ❑CUPA <br /> 1] Housing Abatement 7 AST!HM 1 HW <br /> El Mote[/Hotel <br /> Chicken Ranch/Dog Kennel ❑CUPA <br /> a usT <br /> E]Medical Waste Facility <br /> n Tattoo/Pody Piercing ❑SOLID WASTE <br /> Waste Tire g <br /> ® Complaint <br /> Other(Please Specify): ❑ACCOUNTING <br /> ie <br /> —BOXED AREA-EHD USE DNLY* <br /> 8/28/2017—CALLED APP TO CONFIRM RECEIPT OF PRRA. DOM M <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: EHD 48-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-34201 F 209 464-0138 1 www.sjcehd.com <br />