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From: Enk BBroow'nn Fax:(888)828-2635 To: 12094640138@rcfax.cc Fax: 1209)464-0138 Page 2 of 2 11113/2017 3:10 PM <br /> g'$pE CZWE EHD LOG NUMBER <br /> • sL7RrE��hCCtEE LLL �����1� COUNTY <br /> NOV 13 2011 r - <br /> n-,3 ENVIRENVIRONMENTALHEALTHHEALTHDEPARTMENT 7513 <br /> 4-ter $r^ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> •ENVIRONMEN1.ALWMephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Erik Brown _ SUSINESSIAGENCY: Partner ESI <br /> ADDRESS: 520 Shelly Drive CITY/STATE/ZIP: Pleasant Hill, CA 94523 <br /> PHONE (1): (925)262-8101 PHONE (2): (925)305-5337 FACSIMILE: (888)828-2635 <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 REQUEST- SH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE November 13, 2017 <br /> Electronic Information: ❑ List[IMap—Description: <br /> FILE ADDRESS — EHD USE ONLY <br /> Street f6 Street Name City - <br /> 1234 i South Aurora Street Stockton1� �}�f1—�( � N!%, }v� <br /> i <br /> 2, 1320 South Aurora Street Stockton ) <br /> 3. I <br /> 4. — -- — <br /> C ki • 1,71 H <br /> 5. <br /> -�r1� I <br /> 6• Cit l�—U5 <br /> • 7 0 <br /> 8. <br /> 9. <br /> 10. — <br /> Specifrc Date Range of Information Requested: From All to All <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILITYIVEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> ®UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FooD FACILTY ❑DAIRY <br /> ®ABOVEGROUND TANK ❑CHICKEN RANCHI DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> ®HAZARDOUS WAsreftzARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEmicAL TOILETS <br /> ®TIERED PERMITTED FACILITY ❑PDOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOOISODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-9:00PM(EXCLUDING HOLIDAYS) <br /> t. List up to ten addresses in the space above. Select the type(s)of Hies from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)4640138 or mall to the address Indicated above. Address <br /> ranges will not be 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 he 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$130 deposit prior to review. —Son D AREA.ENn ySE ONLY'" <br /> 11-13-1 - 6 AWA li fnLA XC'- o�t lMu <br /> • ❑ Records provided by Staff-PPR Complete. s aH Name: <br /> Derovt4 <br /> END♦8-ea <br /> Received Time Nov. 13. 2017 3:04PM No. 2584 <br />