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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 /> • GreQmcss grow< herclEtiA11R0 �7ol <br /> IL <br /> EHD LOG NUMBER: <br /> APPLICANT: Eric 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 Ehlers DATE 512/2016 <br /> 1. List up to ten addresses in the space below. Address rangesf 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 FILE ADDRESS <br /> HEALTH DEPARTMENT cC <br /> FILES (Specific addresses only,address ranges will not be accepted) rEHD USE ONLY <br /> Q Underground Tank(UST) N L, Street# Street Name City �J <br /> Cleanup Site(LOP) ` .xAt with"- Corvsuuea <br /> FXJ Other Cleanup Site(Non-LOP) <br /> 14900W. Highway 12 "T, t <br /> Q Hazardous WasteIII� W i� � ( �,'t niav <br /> Q Tiered Permitted Facility 3 14850W. Highway 12 Lodi ` `_ r , <br /> Q Aboveground Tank • ' ` rr s ���,�"5 <br /> OUST (Monitoring/Removal) <br /> 14980 W. Highway 12 Lodi k uv ISO-"{1, J <br /> X Hazardous Materials a I 1 ` <br /> ❑X Spill/Release Response <br /> Q Solid Waste Facility/Vehicle4 14820 W. Highway 12 Lodi U1 ' <br /> O <br /> Food Facility �: I"'rl <br /> Q Pool/Spa (I �n /\ r SnE Mmcnnory <br /> Q Dairy 5 14440W. Highway 12 Lodi a' c- ©� <br /> Q Land Use Application Sites <br /> ouswc <br /> FX Septic Pumper Truck/ 6 <br /> Yard/Chemical Toilets <br /> R Wastewater Treatment Plant CUPA <br /> ❑ Housing Abatement 7 AST I HM I HW <br /> Q Motel/Hotel <br /> Q Chicken Ranch/Dog Kennel z 2rtlUPA <br /> nx Medical Waste Facility 8 UST <br /> M Tattoo/Body,Piercing <br /> Q Waste Tire I 0j ' rq, ! • -tie <br /> e <br /> a <br /> Q complaint '. <br /> Other(Please Specify): ❑ <br /> 10 <br /> `**BOXED AREA-EHD USE ONLY**` <br /> • = - 4br )J612 A& <br /> 4, '.' <br /> ❑ Records provided by Staff-PPR Complet6. Staff Name: EHD 18 06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209464-0138 1 www.sjcehd.com <br />