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C E IVE <br /> , OAQUnv� ronrnental Health Department <br /> -------COUNTY .­ NOV 1 7 ZUV PUBLIC RECORDS RELEASE A PLICATION <br /> (;rec,tr,ess grnFvs ho­.. <br /> EN1fiP8fCAENTALEHD LOG NUMBER:(67 S31 <br /> APPLICANT: Rachel Ward BUSINESSIAGENCY: AEI Consultants <br /> ADDRESS: 5201 3rd Street CITYISTATEIZIP-, Oakland. CA 94607 <br /> PHONE(1): 510.907.3145 x2113 PHONE(2): FAX ORE-MAIL: <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 Nov 9,2017 <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@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. k 1 `� <br /> Future file reviews by the same applicant may require a$152 deposit prior to review. t LI <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 5:00 AM-5:00PM (EXCLUDING HOLIDAYS) <br /> Electronic information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From all to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT y 9 accepted) <br /> EHD 4,. <br /> USE ONLY FILES (Specific addresses only, address ranges will not be acce ted EHD <br /> ® Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) ❑CONSUMER <br /> L_J Other Cleanup Site(Non-C 1 11890 Marian Road LathropVC/N LCM <br /> Hazardous Waste ❑ <br /> DAIRY <br /> 0 Tiered Permitted Facility 2 <br /> Aboveground Tank <br /> ®UST (Monitoring 1 Removal) <br /> ❑PWS <br /> Hazardous Materials 9 <br /> Spill 1 Release Response <br /> ATER QUALITY <br /> Solid waste Facility)Vehicle q <br /> ❑Food Facility <br /> Q Pool!Spa FRI ITE MincanoN <br /> �]Dairy 5 <br /> Land Use Application Sites <br /> ® <br /> Septic PumperTruck d au N� <br /> s A Ill—I <br /> Yard l Chemical Toilets I �� <br /> ®wastewater Treatment Plantj CEPA <br /> ❑Housing Abatement 7 AST f HM 1 HW <br /> ®MotellHotel <br /> Chicken Ranch 1 Dog Kennel b-6UPA <br /> �-I <br /> IJ Medical waste Facility S UST <br /> U Tattoo/Body Piercing Soup WASTE <br /> F1 waste Tire 9 <br /> P71 Complaint <br /> Other(Please Specify): ❑ACeounmNG <br /> 10 <br /> ***BOXED AREA-EHD USE ONLY*** — v <br /> 2 ^ "'�n� J;"vr-��i. �?�- Glc.�wA V'e- <br /> 4 <br /> Records provided by Staff-PPR Complete. staff Name: EHD 48-06 <br /> 1868 E. Hazelton Avenue f Stockton, California 952051 T 2Z468-34201 F 209 464-0138 1 www.sjcehd.com <br />