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��. Q="� <br /> � 7~�/°N~��VED <br /> ' � � Q | � � N ^] ~ <br /> ' ,) � {� ] U�UUY ��3BN 1 ��n�yNronmenW Health Department <br /> ----COUNTY---- UBL|CRECORDS RELEASE APPLICATION <br /> w��� <br /> n�»��x ��� -� �^��ww� <br /> EHDLOG NUK8BER: �� � ° ~ <br /> APpucAmT: CaseySchooner in "I SS/AGENCY:Kimley-Horn and Associates <br /> ADDRESS: 401 B Street,Suite 600 C Y/STATE/ZIP:San Diego.CA 92101 <br /> PHONE(1): 619-744-0111 PHONE(2)�s��34- f <br /> y�� - -- ~ ~ FAX ORE-NA|L: <br /> Please allow 10 business days from date of application submittal for the records to be available, <br /> Staff will contact you toarrange anappointment date and time horeview the requested mcondn. <br /> SIGNATURE OFAPPLICANT casey.schoonercCvkimley-horn.com DATE June 18,2018 <br /> i. List up to ten addresses inthe space below. Address ranges WILL NOT boaccepted. Select the typo(e)offiles from the <br /> list below bychecking the appropriate box(oo). Atleast one file type MUST beselected. Fax to(209)464-0138, mail to the <br /> address indicated below,or email to info(cDsicehd.com. Applications received after 3:UOpmwill boprocessed the next <br /> business day. <br /> 2. For assistance inidentifying tho,naturoand content of EHDrecords, please contact EHDotthe number noted below. <br /> l The EHDwill notify the applicant ifany EHDfiles exist. Anappointment for review will boconfirmed approximately ten (1O) <br /> days after receipt nfapplication. The files will boheld for amaximum offive business days for review. Appointments <br /> should boscheduled 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 D:U0AM'5:0OPM(EXCLUDING HOLIDAYS) <br /> Electronic information: El List E] Map— Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT <br /> FILES (Specific addresses only, address ranges will not be accepted) EHD USE ONLY <br /> Z Underground Tank(UST) Street# Street Name city I <br /> Cleanup Site(LOP) El/.NSUMER <br /> nX Other Cleanup Site(Non-LOP) 1 2487 E Main Street Stockton <br /> nX Hazardous Waste IRY <br /> nX Tiered Permitted Facility 2 <br /> 2498 E Main Street Stockton <br /> nX Aboveground Tank 6M <br /> nX LIST (Monitoring/Removal) El Pws <br /> FX_j Hazardous Materials 2511 E Main Street Stockton <br /> nX Solid Waste Facility/Vehicl " 2524 E Main Street Stockton \Im"WATER QUALITY <br /> F-1 Food Facility No 43 WA T <br /> F] Pool/Spa J�b tyS,6TE MITIGATION <br /> FX]Dairy , 242 S Filbert StocktonnX Land Use Application S!tR/ 13 <br /> nX Septic Pumper Truck 1 2495 E Lafayette Stockton <br /> Yard/Chemical Toilets <br /> Fx_1 wastewater Treatment Plant izuPA <br /> F]Housing Abatement ' 2498 E Lafayette Stockton AST/HM/HW <br /> n Motel/Hotel <br /> E]Chicken Ranch I Dog Kennel �714UPA <br /> FXZ]Medical Waste Facility 8 2500 E Lafayette Stockton X UST <br /> F]Tattoo/Body Piercing [g"SOLID WASTE <br /> rX_1 Waste Tire 9 <br /> Fxj Complaint <br /> Other(Please Specify): E]AOCOUNTING <br /> El Records provided by Staff-PPR Complete. Staff Name: EHD 48-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />