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■� 02/27/2015 14:32 92574660' AEIC,ONSULTANTS PAGE 01/01 <br /> Q <br /> ■ <br /> ■ ®® EHD LOG NUMBEP <br /> e 6 1 I V SAN JOAQUIN COLIN TY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> AUG 2 7 20,5 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �^elephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd D \ , <br /> ENVIRONMENTAL HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> e f P�RIIAIT!@lcRleif•Ce <br /> APPLICANT: Clinton Look BUSINESS/AGENCY: AEI Consultants <br /> ADDRESS: 2500 Camino Diablo CITYISTATE/ZIP: Walnut Creek, Cil.94597 <br /> PHONE (1): 925-746-6016 PHONE (2): FACSIMILE: 925-746-6099 <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 /> ❑ CHECK BOX TO EXPEDITE REQUET $130 FEE(CASH O_R.CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT � DATE 8/27/2015 <br /> Electronic Information: ❑ List❑ Map—Descriptlon: <br /> FILE ADDRESS <br /> EHD USE ONLY <br /> Street# Street Name City <br /> 24567 east L nE tad Escalon <br /> e <br /> , <br /> 2. 24537 East Lone'Free Road Escalon, �<< 'jUnit 1 <br /> 1. 1 <br /> Tc <br /> 3. 24683 (East) Lone Tree Road Escalon El Unit 2 <br /> 4. 24729 (East) Lone Tree Road Escalon r,vi44�` WL i%mk n ❑Unit 2H <br /> 5. <br /> 6. <br /> 7• Unit 4 <br /> $• .12SITE MITIGATION <br /> 9. <br /> 1D- <br /> I]"Unit 5 <br /> Specific Date Range of Information Requortad: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) MEDICAL WASTE FACILITY SOLID WASTE FACILITYNEHtCLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT EWAsTFTIRE <br /> [j(]UNDERGROUND TANK(MONITORIN©/REMOVAL) Q FooD FACILITY g.DAIRY <br /> d-ABOVEGROUND TANK ❑CHICKEN RANCH/Doe KENNEL 9LWASTEWATER TREATMENT PLANT <br /> Qi..HAZARDOUS WASTEiHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCK/YARD/CHEMICAL7oILETS <br /> El--TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOO/BODY PIERCING 'UICOMPLAINTIRESpoNSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL.AND SEPTIC PERMIT RECORDS ARE AVAiLAULE FOR REVIEW: MONDAY-FRIDAY 6:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List un 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(east one file type MUST be selected. Fax to(209)464-4138 or mail to the addrass indicated above. Address <br /> ranges will not b®accepted.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance In Identifying the nature and content of EHD records,please contact EHD at the number noted above. <br /> 3. The END 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 5130 deposit prior to review. 'FOXED AREA-EHD USE ONLY" <br /> n9o) � � ►� �j � 2� 6 L,g,�� `"roe <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> Fun darn 7/7(15 <br /> Received Time Aub. 27. 2015 2. 32PM No. 9434 <br />