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DATE RECEIVED #-- _' EHD LOG NUMBER <br /> SAN JOAQUIN CCff'8- � ;W11 P;Al ;);d <br /> S 06 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> uPIZ 25,11]i 1868 East Hazelton Avenue, Stockton, CA 96206-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www-sjgov.org/and <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT., Jessica Gonzalez BUSINESS/AGENCY: AEI Consultants <br /> ADDRESS: 2500 Camino Diablo CITYISTATE)ZIP: Walnut Creek, CA 94597 <br /> PHONE (1): 925-746-6050 — PHONE (2): 510.688-0941 FACSIMILE: 925-746-6099 <br /> TE/VTATWE*APPOINTMENT DATE: Please call Time: <br /> (Please allow 10 business days from i—date of application submittal_-"TenWllv only-Must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic information: El List F1 Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Strout# Street Name City .'jt, I,1�11e(' El Unit I <br /> 1. 1.621 E Citation Stockton(unincorporated) <br /> 2. 16411 E Citation Stockton(unincorporated) -t pj Unit2 <br /> 3. 6755 C E Dixon Street Stockton(unincorporated) <br /> 4. 6750 s WkH� Stockton(unincorporated) Q <br /> Lome ,�It 3 <br /> 5- 710 Stockton (unincorporated) !L9 <br /> —f 0 SlGunge-StFeetLcr�t X+- <br /> 6. 7199 atotngeltrevt LO!M-e� Stockton(unincorporated) <br /> UnR4 <br /> 7. 1 7679 _S_h�ro5t­ Stockton(unincorporated) 0 <br /> "' ' li8 — Lockheed Court Stockton(unincorporated) El 15 <br /> Unit <br /> S- <br /> Lindbergh Street Stockton(unincorporated) I <br /> LI'Unite <br /> Specific Date Range of Information Requested; From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) E]MEDICAL WASTE FACILITY SOLID WASTE FACILITYIVEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT Z WASTE TIRE <br /> Z UNDERGROUND TANK(MONITORINCIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL WASTEWATER TREATMENT PLANT <br /> HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTEUHOTEL ❑PUMPFRTRUCK/YARDICH5MICALToILEfS <br /> TIERED PERMITTED FACILITY L PUCIJSPA L]We USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING []COMPLAINTIRESPONSE RECORDS [71 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) <br /> 1. List up to ton 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(20!))464-01131ili or mail to the address Indicated above- Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify,the applicant If any EHD flies 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 /> 3. A file that Is actively being worked on by EHD staff may not be Immediately available for review. A new application may be <br /> submitted when the file Is available. <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$1125 deposit prior to review. illiiiilkim& <br /> Nw - <br /> 4"1" '.1 'M RniA" <br /> R? R.N,N rMA' M <br /> #+@5I"O" Age 4off:' t. <br /> I Wr M, _10MIM 1W <br /> F-Me_R1 VEW69, 11 1% <br /> 1 - <br /> llwoo <br /> EHD 046 91d112 ®. <br /> aA <br /> 13/T0 S LN7_I_7MN1771_jV FRla99V/q7R F,q:TT qTQ7./trl/qR <br />