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• <br />�J <br />SAN JO A Q U I N, IVvironmental Health Department <br />'COUNTY JUL i 6) 2018 ��LIC RECORDS RELEASE AP LICATION <br />ENVIRONMENTALHEALTH -7.17 RA EHD LOG NUMBER: <br />APPLICANT: Janet Henkai — BUSINESS/AGENCY: AEI Consultants <br />ADDRESS: 520 3rd Street, Suite 209 CITY/STATE/ZIP: Oakland, CA/94607 <br />PHONE (1): 408-559-7600 PHONE (2): FAX OR E-MAIL: nwmghan4apinnnsiiltantc r.nm <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 DATE July 26, 2018 <br />1. List up to ten 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 infopslcehd.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: <br />Specific Date Range of Information Requested: From all to <br />ENVIRONMENTAL <br />FILE ADDRESS <br />ii Cly TJWJIF <br />HEALTH DEPARTMENT <br />FILES <br />(Specific addresses <br />only, address ranges will not <br />be accepted) <br />EHD USE ONLV' <br />® Underground Tank (UST) a, <br />Street # <br />Street Name <br />City <br />' <br />4239 <br />Newton Road . ` d 1-s {LIAStockton <br />�,p <br />CONSUMER <br />tU <br />l`/,]COT <br />Cleanup Site (LOP) <br />Q Other Cleanup Site (Non -LOP) <br />© Hazardous Waste <br />y`li W �, 1AMC W <br />❑ DAIRY <br />x❑ Tiered Permitted Facility <br />2 <br />4301 <br />Newton Road <br />Stockton <br />AS <br />Aboveground Tank <br />TO <br />PWS <br />® UST (Monitoring / Removal) <br />© Hazardous Materials <br />3 <br />® Spill / Release Response <br />q <br />ATER QUALITY <br />Solid Waste Facility I Vehicle <br />❑ Food Facility <br />ITE MITIGATION <br />Pool / Spa <br />Dairy <br />5 <br />Land Use Application Sites <br />OUSING <br />® Septic Pumper Truck / <br />5 <br />Yard / Chemical Toilets <br />® Wastewater Treatment Plant <br />jrCIPA <br />Housing Abatement <br />7 <br />AST / HM / HW <br />® Motel/Hotel <br />U16-UPA <br />❑ Chicken Ranch / Dog Kennel <br />Medical Waste Facility <br />8 <br />UST <br />Tattoo/Body Piercing <br />VSOLIO WASTE <br />© Waste Tire <br />g <br />® Complaint <br />ACCOUNTING <br />Other (Please Specify): <br />10 <br />—BOXED AREA - EHD USE ONLY*** <br />MOW <br />C <br />� ,/� 1�f � Ilur iI►,� / �.• � 1 �w _ _� i r r �i � � t t � I <br />r —MM <br />_ - <br />i <br />ff-PPR Complete. Staff Name: IFY F EHD 48-06 <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />