Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
01/21/2015 12:28 9257466 AEICCNSULTANTS PAGE 01/01 <br /> DATE RECEIVED EHD LOG NUMBER <br /> SAN .JOAQUIN COUNTY <br /> CEI ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 "AM?b <br /> JAN 1 21�ephorl (209)468-3420 Fax: (209) 484-0138 Web: www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLI8WT-MW11fda BUSINESSIAGENCY:AEI Consultants <br /> ADDRESS: 2500 Camino Diablo CITY/STATE/ZIP:Walnut Creek, CA 94597 <br /> PHONE(1): (925)746.6023 PHONE(2): (530)713-8036 FACSIMILE:(925)746-6099 <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 /> ❑CHECK BOX TO EXPEDITE REQUEST•$1 a0 F F rCASH OR CHECK ONLY)-REQUEST PROCESSED INS BUSINESS DAYS <br /> SIGNATURE OF APPLICANT �n DATE j1?-?1i5 <br /> Electronic Information: ❑ List 0 Map-Description: <br /> ~ FILE ADDRESS EHD USE ONLY <br /> street _ Street Name r city ❑Unit 1 <br /> 1. 9474 Highway 99 North Stockton r <br /> 2. 9454 94tf4 Highway 99 North Stockton ti� ❑Z-7 U_-It 2 <br /> 3. <br /> 4 <br /> S. l ____ ___ ❑Unit 3 I <br /> 6. <br /> .. - ❑Unit 4 <br /> 7. <br /> B. <br /> 9. _ .. [3 unit 5 <br /> 10. <br /> Unit 6 <br /> Specific Date Range of Information Requested: From Earliest to Present <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILRYIVEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE „� (-I 1Pr, t3 . <br /> (�UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY <br /> ❑DAIRY <br /> ©AeOVEGROUNDTANK TREATMENT G✓ <br /> I1 HAZARDOUS WASTFIHAZARDOUS MATERIALS ❑CHICKEN RANCH/DOG KENNEL '0 WASTEWATER ICAL <br /> ❑TIERED PERMITTED FAcLTy ❑PO LISPA FA. ❑PUMPERTRUCKICARON srrs CALTOILETS <br /> ❑TArrooA30DY PIERCING ❑POOL(SPA ©LAND USE APPLICATION SITES <br /> ❑COMPLAIM(RESPONSERECGRDS E]OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUOINO HOLIDAYS) <br /> 1. List-up to ten addresses in the space above. Select the type(s)of Ries from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(208)464-0138 or mail to the address ind➢sated 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 EHD at the number noted above. <br /> 3. The EHD will notify the applicant if any EHD files exist An appointment for review will he confirmed approximately ten(I O) <br /> days after recelpt 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 rile 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$125 deposit prior to review. ""BOXED AREA.EHD USE ONLY"" <br /> "1 1k�.,'c CO cv3o �b i., cAST tie tar Akw q r✓. (-)." q('%. <br /> Jr v lies_ l <br /> d Records provided by Staff-PPR Complete;staff Name: <br /> Received Time-Jai. 21. -2015'12:20PNFNo, 7932 eaeHs <br />