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RECEIVED <br />S A N J O A Q U I N MAY 0 2 2018 Environmental Health Department <br />—COUNTY— �(4ei � PUBLIC RECORDS RELEASE APPLICATION <br />• Grec ress grow< herclEtM. �7ol <br />IL <br />EHD LOG NUMBER: <br />0 <br />APPLICANT: Enc Ehlers BUSINESS/AGENCY: AKT Peerless <br />ADDRESS: 1761 Arlington Blvd CITY/STATEIZIP: EI Cerrito, CA 94530 <br />PHONE (1): 510-529-9555 PHONE (2): FAX OR E-MAIL: ehlerse@aktpeedess.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 Eric Ehlersr­ 11DATE 512/20181. List up to ten addresses in the space below. Address ranges WILL WILL NOT be accepted. Select the types) 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. '/� <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: All files <br />Specific Date Range of Information Requested: From to <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />(Specific addresses <br />FILE ADDRESS <br />only, address ranges will not <br />be accepted) <br />USE ONLY <br />FILES <br />rEHD <br />�J <br />Q Underground Tank (UST) N <br />1, <br />Street# <br />Street Name <br />city <br />1 <br />14900W. <br />H ig hway 12 <br />.xAt whit"- <br />CorvsuuER <br />Cleanup Site (LOP)` <br />FXJ Other Cleanup Site (Non -LOP) <br />Q Hazardous Waste <br />W i ,(..(�, t AIRY <br />Q Tiered Permitted Facility <br />=lasso <br />W. Highway 12 <br />Lodi <br />{ r <br />R Aboveground Tank <br />Q UST (Monitoring / Removal) <br />Q Hazardous Materials <br />I -5 <br />= <br />14980W. <br />Highway 12 <br />�� <br />Lodi,, <br />bJ IrV 0101 ✓ l t t_{pJLLI <br />0X Spill / Release Response <br />ATEA euArm <br />Q Solid Waste Facility/ Vehicle <br />4 <br />1 a82o <br />W . Highway 12 <br />Lod i fl <br />O Food Facility <br />5 <br />14440W. <br />Highway 12 <br />(I <br />Lod��I}dl <br />�n /\ r SnE Mmcnnory <br />"t-�c—©� <br />Q Pool / Spa <br />Q Dairy <br />Q Land Use Application Sites <br />ouswc <br />�X Septic Pumper Truck / <br />6 <br />Yard / Chemical Toilets <br />Q Wastewater Treatment Plant <br />CUPA <br />❑ Housing Abatement <br />7 <br />AST I HM I Hel <br />Q Motel/Hotel <br />Q Chicken Ranch / Dog Kennel <br />8 <br />z EUPA <br />UST <br />nx Medical Waste Facility <br />�� ) <br />F1 Tattoo/Body Piercing <br />1 {Y ,z„ , rg.rq„ ! . • . <br />Q Waste Tire <br />9 <br />`��y <br />Q complaint'. <br />�'(J1 _ <br />❑ <br />Other (Please Specify): <br />10 <br />AM <br />"'BOXED AREA - EHD USE UNLYyY`-- VF P110234 r <br />. <br />❑ Records provided by Staff -PPR Comple . staff Name: EHD48-06 <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 I F 209 464-0138 1 www.sjcehd.com <br />F0 tS <br />