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L4/U1/4V11 1G: Olrrt 111A 31UU04UIUU L`'h'1 Global 100001/0001 <br /> s■ <br /> �ECEIVEP <br /> ■ ■ 'i' � �r6 � �sy� i <br /> ■•■ -i Jowl, If �# 3 k9 l Health Department <br /> f;f8 <br /> • EC Q 12�� PUBLIC RECORDS RELEASE AP LICCATION <br /> • EWRONMEWALHEAM END LOG NUMBER: <br /> APPLICANT: HeatherNilsoG BUSINESS/AGENCY:eFle:obxl <br /> ADDRESS: 5261 west Imperial Highway CITYISTATEfZI P:Los Angeles,CA 301145 <br /> PHONE(1): 3106-A 6:11x) PHONE(2): FAX OR E-MAIL: Reamer Mlson(ojErglmlatemn <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 "' <br /> ,.� -`i'.,5. DATE 1"P2017 <br /> 1. List ug to ton 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@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 /> A. 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. P./1 <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List ❑ Map— Description: <br /> S;3c=cific Date Range of Information Requested: From to <br /> ENVIRONMENTAL F)[ ADDRESS <br /> HEALTH DEPARTMENT Egg USE L <br /> FILES (Specific addresea x11y,addre,s ranges will not be atxepted) fl <br /> IN Underground Tank(UST) Street# Street Namcity <br /> C4a1wp Site(LOP) j � Elt.:'mum <br /> ❑0Lher Cisam!p Sirs(Non-LOP) I 1 1568$1 South Harlan Road La'thgq'op• e1 <br /> • K Hazarbus Male (V f Ej Duan <br /> ❑Tiered Pemitad Facility, ( 4 91 East Thomsen Road Lathrop "r <br /> ❑Abavegrourd Tank 1' <br /> ❑■ UST (Monkaing i Removal) (rM PN(S <br /> 3 15600 South Harlan Road I_� hro _r <br /> Hazardor MatedalE <br /> Ill I Peicane Response l <br /> ❑ <br /> Solid`rVaste Fadl%y;Vehic!s <br /> ❑Food Facility <br /> ❑Pool!Spa ❑sn'c MI OArum <br /> ❑Daiy s <br /> ❑Land Use AoWicsfun Sri's <br /> ❑a¢pGc Rrtplar 7mak t ❑Ixmswr, <br /> 8 <br /> Ymd i Chamkol Toilets <br /> ❑baUPA <br /> Housing Abatement r AST 11;141 nw <br /> ❑MYA:N'Iolel <br /> ❑Clickan Ranch/Dog Kennel ..UPA <br /> B <br /> ❑Medial waste Facility UST <br /> ❑7atl::rvandy Piercing SOLM ftsm <br /> ❑Waste Tina g . <br /> ❑Complaint <br /> ❑otbar(Please Specify): ❑Ac::a:miaa <br /> 10 <br /> BOXED AREA-EHD USE ONLY— <br /> C Records provided by Staff-PPR Com late. stiff Name enc as.oe <br /> 11-»,t, t p,_C;4__ r-ufr i �:e,^a e.l I T 20941uu .4210I H 209464 0 , � <br /> Received Time Dec, 1 2011 12 :44PM P,o 2690` ``' ""`1`'' °�'`" lT` <br />