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RECEIVED <br /> SAN J OAQ U I N Environmental Health Department <br /> ---C OU N T Y -- � L9 0 �' PU IC RECORDS RELEASE AkPLICATION <br /> ,c;FoY.r" Greo?'nese yro;Ys E�iVtR�N(liti&F1ICMIM H-Z.-3 �' <br /> • PEWIT/S1EI�4MS EHD LOG NUMBER: <br /> APPLICANT: Elizabeth HOggatt BUSINESS/AGENCY: AEI Consultants <br /> ADDRESS: 520 3rd Street CITY/STATE/ZIP: Oakland, CA 94607 <br /> PHONE(1): 510.907.3145 x2114 PHONE(2):510-334-6625 FAX OR E-MAIL: aHng9 rcernosliltant�rom <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 DATE April 20,2018 <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)slcehd.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. <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 all to <br /> ENVIRONMENTAL FILE ADDRESS A <br /> HEALTH DEPARTMENT ( p y 9 accepted) EHD USE ONLY <br /> FILES (Specific addresses only,address ranges will not be acce ted <br /> Q Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) Hvj. 1 0 ❑CONSUMER- <br /> RX other Cleanup Site(Non- ' 405 Edison Street Stockton >VO CO/15- <br /> Hazardous <br /> /yHazardous Waste ❑DAIRY <br /> Q Tiered Permitted Facility 2 Case#0000737 <br /> Aboveground Tank <br /> ® UST (Monitoring/Removal) E]PWS <br /> 3 <br /> ©Hazardous Materials <br /> ®Spill/Release Response <br /> ATER QUALITY <br /> ❑Solid Waste Facility/Vehicle 4 <br /> ❑Food Facility <br /> Pool/spa SITE MITIGATION <br /> Dairy 5 <br /> Land Use Application Sites <br /> ❑HOUSING <br /> Septic Pumper Truck/ 6 <br /> Yard/Chemical Toilets <br /> ❑Wastewater Treatment Plant FVC UPA <br /> ❑ Housing Abatement 7 AST]HM/HW <br /> ❑ Motel/Hotel <br /> Chicken Ranch/Dog Kennel CUPA <br /> g UST <br /> ❑ Medical Waste Facility <br /> ❑Tattoo/Body Piercing ❑SOLID WASTE <br /> Waste Tire 9 <br /> Complaint <br /> Other(Please Specify): ❑ACCOUNTING <br /> fo <br /> ***BOXED AREA-EHD USE ONLY <br /> • �t'�"5 �' C �'r ^L '4 t <br /> OA— <br /> ❑ Records provided by Staff-PPR Complete. staff Name: EHD 48-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />