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o: Page 2 of 2 2014-08-27 20:09:34 (GMT) 14155205858 From: Carrie Locke <br />DATE RECEIVED SAN JOAQUIN COUNTY EHD LOG NUMBER <br />AUG ZQ1� ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 qs <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />ENVIRONMENTAL HEALTH <br />PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: Carrie Locke <br />ADDRESS: 1819 Jackson Street <br />BUSINESS/AGENCY: AEI Consultants <br />CITY/STATE/ZIP. San Francisco, CA 94109 <br />PHONE (1): 415-505-8090 PHONE (2): FACSIMILE: 415-520-5858 <br />TENTATIVE* APPOINTMENT DATE: Please call Time: <br />(Please allow 10 business -days from date of application submittal -*Tentative only- must be confirmed) <br />❑ CHECK BOX TO EXPEDITE REQUEST - $125 FEE (C H O K ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />7 <br />SIGNATURE OF APPLICANT DATE 08-27-14 <br />Electronic Information: ❑ List ❑ Map — Description: <br />FILE ADDRESS <br />EHD USE ONLY <br />U n I t-4 <br />Street # <br />Street Name <br />City <br />1. <br />1001 <br />Stokes Avenue <br />Stockton <br />�} I <br />Ernit 2 <br />2• <br />f <br />! <br />3. <br />V <br />nit 3 <br />4. <br />5. <br />p'lfnit 4 <br />6. <br />7. <br />_E] Unit 5 <br />8. <br />G�'� <br />9. <br />13 -Unit 6 <br />10. <br />Specific Date Range of Information Requested: From <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />® UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ® MEDICAL WASTE FACILITY <br />® OTHER CLEANUP SITE (NON -LOP) ® HOUSING ABATEMENT <br />® UNDERGROUND TANK (MONITORINGIREMOVAL)—/— ❑ FOOD FACILITY <br />® ABOVEGROUND TANK c�, ❑ CHICKEN RANCH/ DOG KENNEL <br />® HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑ MOTEL/HOTEL <br />® TIERED PERMITTED FACILITY ❑ POOLISPA <br />❑ TATTOOIBODY PIERCING ® COMPLAINTIRESPONSE RECORDS <br />to <br />® SOLID WASTE FACILfI IYIVEHIC,LE <br />® WASTE TIRE 3 {9 lC5 <br />❑ DAIRY <br />® WASTEWATER TREATMENT PLANT <br />® PUMPER TRUCKIYARDICHEMICAL TOILETS <br />❑ LAND USE APPLICATION SITES <br />❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) <br />1. Llst up to ten addresses in the space above. Select the type(s) of files.from 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 -for additional assistance with file addresses, contact the EHD. Applications received after <br />3:00 pm will be processed the next business day. <br />2. 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 />3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may be <br />submitted when the file is available. <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 tjhe same applicant may require a $125 deposit prior to review. QX DARE � ETD [t E�13lF Y <br />