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03/23/2015 13:15 9257466 <br /> AEICONSULTANTS� PAGE 01/01 <br /> ■ ■ EHD LOG NUMBER <br /> ■:. SAN .IOAQUIN COUNTY syn <br /> YENVIRONMENTAL HEALTH DEPARTMENT <br /> MAR 2 3 2015 1 �u1V� <br /> 868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> ENVIRONMENTALHEALTH <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:Clinton Look BUSINESS/AGENCY:AEI Consultants <br /> ADDRESS: 2500 Camino Diablo CITYISTATE/ZIP:Walnut Creek,CA <br /> PHONE (1): 925.746.6016 PHONE (2): FACSIMILE: 925-746-6099 <br /> Please allow 10 business days from date of application submittai 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 REQUES r$1 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: [] List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name city _ 1 <br /> 1. 3550 South Highway 99 Stockton ww J <br /> 2. 3736 South Highway 99 Stockton C G'''` s S unit 2 <br /> 3. I ttiuil 7/ <br /> 4, <br /> 1N <br /> V0. 1 <br /> _. ... We I-1 �(�rS CL wjj -0-Urit4 <br /> 1 c.® <br /> DUnit5 <br /> p-Unit& <br /> Specific Date Range of Infomnalion Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILETS <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ®MEDICAL WASTE FACILITY ®SOLID WASTE FACIUrrYNEHICLE <br /> OTHER CLEANUPSITE(NDN-LOP) Q HOUSING ABATEMENT ®WASTE TIRE <br /> ®UNDERGROUND TANK(MONTORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ADOVEGROUNn TANK ❑CHICKEN RANCH/DOG KENNEL ®WASTEWATER TREATMENT PLANT <br /> ®HAZARDOUS WAsTE1HAZARDOUS MATERIALS ❑MOTELHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ®TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USEAPPLICATION STES <br /> ❑TATTOOIBODY PIERCING ®COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 5:00 AM-5:00PM (EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the type(s)of flies from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail 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 EMD at the number noted above, <br /> 3. The EHD will notIfy the applicant if any EHD flies exist. An appointment for review will be confirmed approximately ten(10) <br /> days atter receipt of application. The flies 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 reorgani2ad 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 /> (a,, 'u; � Ua3bT�) i ••tN�1-la�+er-lle�� �73G �w H4. <br /> 9W A %0& ,4 e4ig 9• Lot Cc7Cal 7t `i:� . <br /> r- C 03 1'("77 Z S i tj PtSt ''i gr 57J 11 4"1. <br /> Dal4XI-^ .Cv,t "Sip <br /> Records provided by Staff-PPR Complete. Staff Name: <br /> Received Ilme-Mar. 23. -2015= 1 , 16PM=No. 8383 4=114 <br />