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SA N tJ OAQ U I N �d Environmental Health Department <br /> .: . COUNTY A� PUBLIC RECORDS RELEASE APPLICATION <br /> Greatness grows her _ n �V <br /> SUBMIT BY EMAIL � <br /> EHD LOG NUMBER: <br /> APPLICANT: Erik Brown BUSINESS/AGENCY:Partner ESI <br /> ADDRESS: 520 SHELLY Drive CITY/STATE/ZIP:Pleasant Hill,CA 94523 <br /> PHONE(1): 925-262-8101 PHONE(2):925-305-5337 FAX OR E-MAIL: Erik@mnm-env.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 Erik Brown DATE 8/10/18 <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 infoasicehd.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. ii <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS),Y1'\ <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS C D 2z I <br /> HEALTH DEPARTMENT <br /> FILES (Specific addresses only,address ranges will not be accepted) EHD USE O Y <br /> xj Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) 1 LJ LJ V V^5^ ,/�/ Yettner Road Frenc <br /> ❑CONSUMER <br /> FX Other Cleanup Site(Non-LOP) W. h Camp <br /> 0 Hazardous Waste <br /> ❑DAIRY <br /> I]Tiered Permitted Facility 2 <br /> Q Aboveground Tank <br /> UST (Monitoring/Removal) ❑PWS <br /> Q Hazardous Materials 3 <br /> Q Spill/Release Response <br /> ❑WATER QUALITY <br /> Solid Waste Facility/Vehicle 4 <br /> Food Facility <br /> Pool/Spa ❑SITE MITIGATION <br /> Dairy 5 <br /> F]Land Use Application Sites <br /> ❑HOUSING <br /> F]Septic Pumper Truck/ 6 <br /> Yard/Chemical Toilets <br /> 171 Wastewater Treatment Plant gCUPA <br /> ❑ Housing Abatement 7 AST/HM IHW <br /> Ll Motel/Hotel <br /> ❑Chicken Ranch/Dog Kennel ❑CUPA <br /> 8 <br /> Medical Waste Facility UST <br /> ❑Tattoo/Body Piercing ❑SOLID WASTE <br /> Waste Tire g <br /> Complaint <br /> Other(Please Specify): ❑ACCOUNTING <br /> 10 <br /> ***BOXED AREA-EHD USE ONLY*** <br /> 2 — 2 2L 2IN e vvrt <br /> 0 51 I in <br /> O 0 <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: !EHD 48-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />