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■o <br /> W�■ EHD LOG NUMBER <br /> HEN 'FET— V ED `" SAN JOAQUIN COUNTY � <br /> 0■ ENVIRONMENTAL HEALTH DEPARTMENT t <br /> OCT 2 0 2014 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web; www.sjgov.org/ehd <br /> ENVlRONMENTALHEALTH <br /> 0r=9MITlsFRVI Es PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Llta Freeman BUSINESS/AGENCY: AEI Consultants <br /> ADDRESS: 1420 E Roseville Pkwy,#140-262 CITY/STATE/Zip: Roseville, CA 95661 <br /> PHONE(1): 916-677-9897 PHONE (2): FACSIMILE; <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(GASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 10/10/1.4 <br /> Electronic Information: ❑ Llst❑ Map—Descrlptlon: <br /> FILE ADDRESS EHO USE ONLY <br /> g4. <br /> Street Name city ❑Unit 1 <br /> Broadway Avenue Stockton ti TBroadwa Avenu Stockton ' �� 4Q4Dnit <br /> . Nt3 <br /> 8. <br /> unit 4 <br /> 7. <br /> 8. <br /> ❑Unit 5 <br /> 9. <br /> 10. <br /> ui-CJrrit 6 <br /> Specific Date Range of Information Requested; From 1940 to present <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> IN UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 1]MEDICAL WASTE FACILITY <br /> El OTHER CLEANUP WE(NON-LOP) ElSOLID TIRE 3, ACILI�T"YNE160 <br /> ( ) ❑HOUSING ABATEMENT El WASTE TIRE � �-r�PS� iLQ �^'r' <br /> ®UNDERGROUND TANK(MONITORING/REMOVAL) ❑FOOD FACILITY El DAIRY LtA i 1 3. I Z I (l <br /> ®A90VEGROUND TANK ❑CHICKEN RANCH/Doe KENNEL E 1 <br /> ❑WASTEWATER TREATMENT PLANT <br /> I2 HAZARDOUS WASTE/HAZARDOUS MATERIALS ❑MOTELIHOTEL <br /> ®TIERED PERMITTED FACILITY ❑PUMPER E Appucmioli SITES L TOILETS <br /> ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOOMODY PIERCING ®COMPLAINT/RESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses In the space above, Select the type(s)of files front 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 EMD records,please contact EMD 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 he 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 relaasod 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 ONLY" <br /> rt)J f E& 4 l 2 Gb213 <br /> 5 o- q05 A:Ba <br /> a U2 <br /> Received Time Oct. 20. 201um No, 366 (fir 1105 tt _ /Z-3—lu' rOv,do cIfff'�e/l� <br />