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RECEIVED <br /> '¢k-`°`; —COUNTY—SANJOAQUIN Environmental Health Department <br /> DEC 2 201? PUBLIC RECORDS RELEASE APPLICATION <br /> • " Greatness grows here.EWRO(NIMEINTpLFIp Q vcl77y <br /> PEIlMIT/SEFMtE9 I t-Z 7 EHD LOG NUMBER: ( <br /> APPLICANT: Jessica Malone BUSINESS/AGENCY: AECOM <br /> ADDRESS: 625 W. Ridge Pikem, Suit E100 CITY/STATE/ZIP: Conshohocken, PA 19428 <br /> PHONE(1): 610-832-6198 PHONE(2): FAXORE-MAIL: lessica.malone@ <br /> Please allow 10 business days from date of application submittal for the records to be available. aecom.com <br /> Staff will contact you to arrange an anoointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT ram B /Zwl DATE 12/27/2017 <br /> 1. List up to ten addresses in the space.,.,...... ..__..,..,..-ages 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 infor0sicehd.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. I <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-5:0013M(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List ❑ Map-Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT p y g accepted) EHD USE ONLY <br /> FILES (Specific addresses only,address ranges will not be ecce ted <br /> ®Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) '0 ❑CONSUMER <br /> • �Other Cleanup Site(Non-LOP) 4730 Fite Court Stockton M 1 <br /> ®Hazardous Waste ❑DAn, <br /> ©Tiered Permitted Facility <br /> ®Aboveground Tank 1J <br /> ®UST (Monitoring I Removal) �/�(.�� �1 ❑PWS <br /> ®Hazardous Materials - <br /> ®Spill/Release Response <br /> 1 aTaa aunuTv <br /> ❑Solid Waste Facility/Vehicle q CX U%j <br /> ❑Food Facility <br /> ❑Pool/Spa S.-Mi <br /> ❑Dairy S <br /> cLf <br /> ❑Land Use Application SitesHousirva <br /> ❑Septic Pumper Truck/ S , 1 ` <br /> Yard/Chemical Toilets J1-1`W <br /> ❑Wastewater Treatment Plant CUPA <br /> ❑Housing Abatement 7 AST/HM/HW <br /> ❑MotellHatel <br /> CU PA <br /> F-1ChickenRanch/Dog Kennel <br /> a UST <br /> ❑ Medical Waste Facility <br /> E]Tattoo/aody Piercing ❑SOLID WASTE <br /> ❑Waste Tire 9 <br /> ❑Complaint <br /> ❑Other(Please Specify): ❑�uunrve <br /> 10 <br /> `"`BOXED AREA-EHD USE ONLY <br /> • �'I-II - �rti:l cel ¢, PMA parr-e 04 ekw ani. t.e YE=tlt.S. tly'�t <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: EHD 9a-0a <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />