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om:Erik Brown Fax:(888)828-2635 To: 12094640138@rcfax.cc Fax: +12094640138 e 2 of 2 04109/2015 10:36 AM � ' A' Rp EHD LOG NUMBER T SAN JOAQUIN COUNTY APR 0 9 2015 ENVIRONMENTAL. HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 E'yVIR0NMENTAL HEALI'FI Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www,sjgov.org/ehd pERNIVI"ISEWICCS PUBLIC RECORDS RELEASE APPLICATION APPLICANT: Erik Brown BUSINESS/AGENCY: Partner ESI ADDRESS: 520 Shelly Drive CITY/STATE/ZIP: Pleasant Hill, CA 94523 PHONE(1): (925)262-8101 PHONE (2): (925)305-5337 FACSIMILE: (888)828-2635 Please allow 10 business days from date of application submittal for the records to be available. Staff will contact you to arrange an appointment date and time to review the requested records. ❑ CHECK BOX TO EXPEDITE REQUEST- SH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS SIGNATURE OF APPLICANT DATE April 9, 2015 Electronic Information: ❑ List❑ Map–Description: FILE ADDRESS END USE ONLY --f—street# Street Name City - __❑Unit 1 1. 2895 North Naglee Road Trac 1'If Iv F `J 2. I ❑Unit 2 3. �l 4. ❑Unit 3 5. -3 _6' ._ ❑Unit 4 7. 8• ❑Unit 5 9. 10. I ❑Unit s Specific Date Range of Information Requested: From All to All ENVIRONMENTAL HEALTH DEPARTMENT FILES UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILITYNEHICLE ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE [X UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY ®ABOVEGROUND TANK ❑CHICKEN RANCH)DOG KENNEL ❑WASTEWATER TREATMENT PLANT ®HAZARDOUS WASTE/HAZARDOUS MATERIALS ❑MOTEL/HOTEL ❑PUMPER TRUCK/YARDICHEMICAL TOILETS TIERED PERMITTED FACILITY ❑POOL/SPA ❑LAND USE APPLICATION SITES ❑TATTOO/BODY PIERCING ❑COMPLAINT/RESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address Indicated above. Address ranges will not be accepted.Appilcatlons received after 3:00 pm will be processed the next business day. 2. For assistance In identifying the nature and content of EHD records,please contact EHD at the number noted above. 3. The EHD will notify the applicant If any EHD flies exist. An appointment for review will be confirmed approximately ten(10) days after receipt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant. Future file reviews by the same applicant may require a$130 deposit prior to review. "'BOXED AREA-EHD USE ONLY` ❑ Records provided by Staff-PPR Complete. Staff Name: EHn 4646 08/01114 Re c e i ve d T i me_Ap r. 9. _201 5_10: 36AM_No.