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II #. EIVED <br /> SAN J 0 A 0 U I N, Environmental Health Department <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> ENVIRONi!thE,NT.P,1. ���(,� <br /> ` <br /> PENMIT/.SEft', Y EMAIL <br /> EHD LOG NUMBER: <br /> LJ <br /> APPLICANT: Nicholas Rowe BUSINESS/AGENCY: Services <br /> ADDRESS: 1137N Lathrop CITY/STATE/ZIP:foanfeca CA 95336 <br /> PHONE(1): 559.802.5267 PHONE(2): FAX OR E-MAIL: nlckrowe@lcservices com <br /> Please allow 10 busine d s from date of application submittal for the records to be available. <br /> Staff will Contac 81 ra an app9intmelTdate and time to review the requested records. <br /> SIGNATURE OF APPLICANT - DATE <br /> 1. List up to ten addresse 'n t elow. 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( sicehd.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. <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: Piping drawing for fuel equipment <br /> Specific Date Range of Information Requested: From 2009 to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT <br /> FILES (Specific addresses only,address ranges will not be accepted) EHD USE ONLY <br /> X❑underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) CONSUMER <br /> Other Cleanup Site(Non-LOP) 1 1137 W. Lathrop Manteca <br /> M Hazardous Waste ❑DAIRY <br /> Tiered Permitted Facility 2 <br /> Aboveground Tank <br /> UST (Monitoring/Removal) ❑PWS <br /> Hazardous Materials 3 <br /> Spill/Release Response _ ❑WATER QUALITY <br /> Solid Waste Facility I Vehicle 4 <br /> Food Facility Lr lC <br /> Pool/Spa ❑SITE MITIGATION <br /> Dairy 5 <br /> ❑Land Use Application Sites <br /> ❑HOUSING <br /> Septic Pumper Truck/ 6 <br /> Yard/Chemical Toilets <br /> Wastewater Treatment Plant ❑CUPA <br /> Housing Abatement 7 AST;HM I HW <br /> Motel/Hotel <br /> ❑Chicken Ranch/Dog Kennel ❑CUPA <br /> 8 UST <br /> ❑Medical Waste Facility <br /> ❑Tattoo/Body Piercing SOLID WASTE <br /> F]Waste Tire 9 <br /> ❑Complaint <br /> Other(Please Specify). ❑AccOUNnNG <br /> 10 <br /> •"BOXED AREA-EHD USE ONLY'A' <br /> C 1,i t > .. ( /—SL-A "t, o/ 1'0 ;r [/ <br /> Records provided by Staff-PPR Complete. Staff Name: j2,ttCx 1 CQ 0 O t _C — EHD 4"6 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />