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RECEIVED <br />SAN'JOAQUIN j A 2 a 2016 Environmental Health Department <br />--COUNTY-IERIIiaOPAdEF(TALFWAi]i-! ��S�RECORDS RELEASE APPLICATION <br />• PEMMIT/SER CES (oL6 EHD LOG NUMBER: `' 0 ! 2- <br />APPLICANT: Natalie Vaughan BUSINESS/AGENCY: AEI Consultants <br />ADDRESS: 3880 S Bascom Ave, Suite 109 CITY/STATE/ZIP: Oakland, CA 94607 <br />PHONE (1): 408-550-7600 PHONE (2):925-922-4900 FAX OR E-MAIL: n,mighan4npinnnsadfantgrom <br />Please allow 10 business days from date of application submittal for the records to be available. <br />Staff will contact you to ar on a an arppointment date and time to review the requested records. <br />SIGNATURE OF APPLICANT Nata71 e �/arw ail DATE June 27, 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 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. /6 <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) <br />• <br />Electronic Information: U List U Map — Description: <br />Specific Date Range of Information Requested: From all to <br />ENVIRONMENTAL <br />FILE ADDRESS <br />A <br />Q 1,z�2q�3U <br />HEALTH DEPARTMENT <br />FILES <br />S ecific atldresses <br />(Specific <br />onlyaddress ran es will not <br />y g <br />be acce ted <br />p ) <br />EHD <br />U S ONLY <br />p1 Underground Tank (UST) <br />E] <br />Street # <br />Street Name <br />city <br />' <br />771 <br />East Roth Road <br />CONSUMER <br />Cleanup Site (LOP) <br />Q Other Cleanup Site (Non -LOP) <br />N.WrdWCam <br />© Hazardous Waste <br />• <br />i, N �� <br />µyy�p,� DAIRY <br />Q Tiered Permitted Facility <br />3 <br />783 <br />East Roth Road <br />French Cam <br />111 r �U1' 1 <br />[X] Aboveground Tank <br />a <br />787 <br />❑ PWS <br />® UST (Monitoring / Removal) <br />�] Hazardous Materials <br />East Roth Road <br />IdJSpill / Release ResponseA <br />Cam <br />4 <br />791 <br />East Roth Road <br />Cam <br />",6a °M"°'Y <br />LtJ Solid Waste Facility / Vehicle <br />Food Facility <br />01rer <br />6 <br />795 <br />East Roth Road <br />French Cam <br />Srsrta Mmo"RON <br />❑ Pool / Spa <br />❑ Dairy <br />] Land Use Application Sites <br />6 <br />ousiNc <br />® Septic Pumper Truck / <br />Yard I Chemical Toilets <br />® Wastewater Treatment Plant <br />(CUPA <br />E] Housing Abatement <br />r <br />AST IHM IHW <br />® Motel/Hotel <br />[0 CUPA <br />❑ Chicken Ranch / Dog Kennel <br />�] Medical Waste Facility <br />UST <br />Tattoo/Body Piercing <br />Sam WnsTE <br />I9 Waste Tire <br />g <br />® Complaint <br />ElAccoumTI <br />E] Other (Please Specify): <br />10 <br />"'BOXED AREA - EHD USE ONLY* <br />1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />