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CEIVEb SAN JOAQUIN COUNTY EHD LOG NUMBER <br />DEC j 2 2016 ENVIRONMENTAL HEALTH DEPARTMENT 95149 <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />�ltt ALF phone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />P EMMrfMERff_:rE <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: Lauren Sagun BUSINESS/AGENCY: EFI Global <br />ADDRESS: 5261W. <br />PHONE (1) <br />310-854-6300 <br />CITY/STATE/ZIP: Los <br />PHONE (2): FACSIMILE: <br />CA 90045 <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 - $130 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT <br />Electronic Information: ❑ List ❑ Ma <br />— Description: _ <br />12/9/2016 <br />FILE ADDRESS <br />EHD USE ONLY <br />El Unit i <br />Street # <br />Street Name <br />City <br />1. <br />103 <br />West 11th St. <br />Tracy <br />LJn+ Dr+S —co <br />LOP}Re oriny Co (/Unit2 <br />Lop_ co <br />49P}- PC(cr - CO E/Unit3 <br />2. <br />3. <br />95 <br />1131 <br />West 11th St. <br />Holly Dr. <br />Tracy <br />Tracy <br />4. <br />1034 <br />Central Ave <br />Tracy <br />5. <br />68 <br />East 11th St. <br />Tracy <br />L.01" t f+4 -c,Q <br />ICUPA— <br />[11 wril" <br />6. <br />�. <br />�r��k►Qa co, <br />n <br />Oyr- ❑ Unit 5 <br />8. <br />g. <br />Iz-t3-Ib <br />❑ Unit 6 <br />10. <br />Specific Date Range of Information Requested: From earliest to present <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />❑� UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ MEDICAL WASTE FACILITY <br />❑ OTHER CLEANUP SITE (NON -LOP) ❑ HOUSING ABATEMENT ❑SOLID WASTE FACILITYNEHICLE <br />❑ WASTE TIRE <br />❑� UNDERGROUND TANK(MONITORINGIREMOVAL) F1 FOOD FACILITY <br />❑� ABOVEGROUND TANK ❑DAIRY <br />❑ CHICKEN RANCH/ DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br />HAZARDOUS WASTEMAZARDOUS MATERIALS ❑ MOTELMOTEL ❑ PUMPER TRUCKIYARDICHEMICAL TOILETS <br />❑ TIERED PERMITTED FACILITY ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br />❑ TATTOoIBODY PIERCING ❑ COMPLAINTIRESPONSE RECORDS <br />❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) <br />1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checking the appropriate <br />box(es). At least one file type MUST be selected. Fax to (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 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 $130 deposit prior to review. ***BOXED AREA - EHD USE ONi Y*** <br />V40 <br />14 <br />