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SAN AN 10A <br /> Environmental Health Department <br /> COUNTY--NAR 0 8 2WPUBLIC RECORDS RELEASE APPLICATION <br /> / J <br /> • :%+l.,Poar GrhOtnetisrows I - �BY EMAIL \/) <br /> ENVIRQNMESYdALF� c EHD LOG NUMBER: \/ <br /> P3€fifl91TF5'€R'A <br /> APPLICANT: Carrie Locke BUSINESS/AGENCY:AEI Consultants <br /> ADDRESS: 1819 Jackson Street,Apt.4 CITY/STATE/ZI P:San Francisco,CA 94109 <br /> PHONE(1): 415-505-8090 PHONE(2): FAX OR E-MAIL: camie.laeke@gmail.com <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 reviewthe requested records. <br /> SIGNATURE OF APPLICANT Carrie E.Locke °"`;'o;°m`p;. DATE March 7,2018 <br /> 1. List ua 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 Nle type MUST be selected. Fax to(209)464-0138,mail to the <br /> address indicated below,or email to infoOlsicehd.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. /l <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 to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT Cf� <br /> FILES (Specific addresses only,address ranges will not be accepted) EHD USE <br /> X% <br /> Underground Tank(UST) Street# Street Name City ( / <br /> Cleanup Site(LOP) �A.A ❑Caysuuan \`IJ// <br /> �X Other Cleanup Site(Non-LOP) <br /> 3356 W. Yosemite Avenue Lathrop <br /> FX Hazardous Waste \\ DAR, <br /> Mx Tiered Permitted Facility 2 3128 W. Yosemite Avenue Lathrop L` Iv� ❑ <br /> Q Aboveground Tank <br /> FX UST (Monitoring/RDTI _,\ ❑PWS <br /> Q Hazardous Materials 3 3356 Highway 120 Lathrop 1" <br /> Q Spill/Release Response <br /> O Solid Waste Facility/Vehicle 4 3128 Highway 120 Lathrop 4K <br /> ti(WATEe QUALITY <br /> Food Facility <br /> ❑ Pool/Spa \\�j SiTs MITIGATION <br /> ❑ Dairy 6 18389 S. McKinley Avenue Lathrop t� <br /> L] Land Use Application Sites <br /> x❑Septic Pumper Track/ <br /> Yard/Chemical Toilets ousiec <br /> 18635 S. McKinley Avenue Lathrop <br /> Q t Wastewater Treatment PlanO COPA <br /> O Housing Abatement 7 (j AST/HM/HW <br /> Motel/Hotel <br /> Chicken Ranch/Dog Kennel CUPA <br /> Q Medical Waste Facility a UST <br /> ❑Tattoo/Body Piercing �pp SOLID WASTE <br /> ❑X Waste Tire g (J i ✓! <br /> ❑x Complaint Oaf a <br /> Other(Please Speciry): Accouunrve <br /> 10 l�_/✓� N/ <br /> n <br /> ***BOXED AREA-EHD USE ONLY— <br /> • <br /> ❑ Records provided by Staff-PPR Complete. staff Name: EHD48G6 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />