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Fr..:AEI Consultants 408 558 760106/]15 13:31 #675 P.001/001 <br /> 01 0 <br /> JATE RECEIVED EHD LOG NUMBER <br /> SAN .10AQUIN COUNTY <br /> X <br /> EC'D JUN 0 2 2015 ENVIRONMENTAL HEALTH DEPARTMENT Z(;® <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Max Martinez BUSINESS/AGENCY:AEI Consultants <br /> ADDRESS: 3880 S. Bascom Avenue CITY/STATEIZIP:San Jose, CA 95124 <br /> PHONE (1): 408-559-7600 PHONE(2): FACSIMILE:408-559-7601 <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-$130 FEE(CAS R CHECK ONLY)-REQUEST PROCESSED INl3 BUSINESS DAYS G/I rf <br /> SIGNATURE OF APPLICANT DATE 6I SII S <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑Unit 1 <br /> 1. 1111 Navy Drive Stockton rn 9 MP <br /> 1240 Navy Drive Stockton { r 97unl fz <br /> 3. 1055 S. Stockton Street Stockton <br /> 4. 1137 S. Stockton Street Stockton -r # Un.3 <br /> 6. Unit 4 <br /> 7. Flit ani �(0 <br /> — n,�o'w1eJrJ S <br /> 8. ❑Unit 5 <br /> 9. <br /> 10. G-I�-tS <br /> ❑Uni4 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILITYNEHICLE <br /> THER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> NDERGROUND TANK(MONRORWGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> BOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> AZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICALTOILETS <br /> TIERED PERMITTED FACILITY `�"-DOOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOOBODY PIERCING LTJ C'OMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(2091464.0138 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 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$125 deposit prior to review. 'BOXED AREA-EHD USE ONLY*" <br /> '-Zatllec AW. w5 �" Wnl Oe6f 0U F AAe c e, Ali hLI W/MAti1 <br /> -t - Le'L-k r'^ mieh "F 4-iii0 o -&te Al fur 4�l Lid Car III r- // Kn <br /> o•-� tiny 3 4 6CO mi'95t%0 k IM wre',A , t-kv Ue for Illi r /y,(.o ti5^ <br /> I�. <br /> ❑ Records provided by St ff-PPR Complete- staff Name: t/,to (� IA'M+ l G d L 4 3 u1s <br /> P.rea ilv.J T;m.('i� 9 9MI 9. 17P� -,N„ PPA6 A .'i-t e.., r)L- r — Vius Aa... IL U1LLA 42a/t4 <br />