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EIVIE�b <br /> t S AN J 0 A 0 U IN it 201b Environmental Health Department <br /> ---C G U N T Y-- <br /> 1MWW <br /> PU�BLId RECORDS RELEASE�3?276H <br /> AP <br /> YEHD LOG NUMBER: <br /> APPLICANT: Erik Brown BUSINESS/AGENCY:AEI Consultants <br /> ADDRESS: 520 Shelly Drive CITY/STATE/ZIP:Pleasant Hill,CA 94523 <br /> PHONE(1): 925-262-8101 PHONE(2): FAX OR E-MAIL: ERIK@MNM-ENV.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 review the requested records. <br /> SIGNATURE OF APPLICANT Erik Brown DATE LI <br /> 1. List up 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 file type MUST be selected. Fax to(209)464-0138, mail to the <br /> address indicated below, or email to info(a)sicehd.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. ti•l <br /> Future file reviews by the same applicant may require a$152 deposit prior to review. <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 -"'D -t —2 <br /> HEALTH DEPARTMENT ( p y 9 accepted) EHD USE ONLY <br /> FILES (Specific addresses only,address ranges will not be acce ted <br /> x�Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) ttm SP, Co asp ❑CONSUMER <br /> QOther Cleanup Site(Non-L ' 2402 South California Street Stockton <br /> ❑X Hazardous Waste \ <br /> ❑DAIRY <br /> Q Tiered Permitted Facility� 2 <br /> FX Aboveground Tank w7 v l l: <br /> A. <br /> QX UST (Monitoring/Removal) ❑PWS <br /> ❑X Hazardous Materials 3 <br /> ❑X Spill/Release Response <br /> ATER QUALITY <br /> Solid Waste Facility!Vehicle 4 NA <br /> ❑Food Facility <br /> ❑Pool/Spa SITE MITIGATION <br /> ❑Dairy 5 <br /> ❑Land Use Application Sites <br /> HOUSING <br /> Q Septic Pumper Truck/ ❑ <br /> s <br /> Yard/Chemical Toilets <br /> Q Wastewater Treatment Plant CUPA <br /> Housing Abatement 7 AST I HM I HW <br /> F1 Motel/Hotel <br /> ❑Chicken Ranch/Dog Kennel (CUPA <br /> Medical Waste Facility 8 UST <br /> F1 Tattoo/Body Piercing ❑SOLID WASTE <br /> Waste Tire g <br /> Complaint <br /> Other(Please Specify): ❑AccouNTING <br /> 70 <br /> —BOXED AREA-EHD USE ONLY <br /> rim Cn11 _hlfl c)'� v 4� L <br /> 2c-)--1 3 0 3-tr 51 <br /> Ce-2c2—cx otad <br /> ❑ Records provided by Staff-PPR Complete. staff Name: EHD 48-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />