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RECEIN 0 <br /> fED <br /> SAN JOA0A Environment Health Department <br /> C 0 U 1\J I Y---- <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> PE1.Wrr1S'MAb.E5 ou <br /> EHD LOG NUMBER. <br /> APPLICANT: Natalie Vn augha — — —1 <br /> BUSINESSIAGENCY: AE1 Consultants <br /> ADDRESS: 3880 S Bascom Ave Suite 109 CITY/STATEIzIP: Oakland, CA 94607 <br /> PHONE (1): 408-550-7600 PHONE(2):925-922-4900 FAX OR E-MAIL- LigLar@aeimnsuftanjs <br /> ny -Qom_ <br /> 0 <br /> Please allow 10 business business days from date.of application submittal for the records to be available. <br /> Staff will contact you to arrpn e an a <br /> N, t ent date and time to review the requested records. <br /> SIGNATURE OF APPLICANT Vgciin rn <br /> r6 aR DATE June 2l,2018 <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 chocking the appropriate box(es). At feast one file type MUST be selected Fax to(209)4134-0138� mail to the <br /> address indicated below or email <br /> business day, �we Applications received after 3:00' pm will be processed the next <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 atter receipt of application. The files will be held for a maximum of five business days for review. Appointments <br /> shouldbe scheduled accordingly. <br /> � <br /> 4. Any fil not returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant. <br /> Future ile reviews by the same applicant may require a$152 deposit prior to review. W- <br /> WELL AID SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> rElectrons Information: El List 0 Map—Description: <br /> Specific Date Range of Information Requested: From <br /> I all to <br /> ENVIR0N ENTAIL <br /> HEALTH DEPARTMENT FILE ADDRESS f-r e-2, 7 <br /> MILES (Specific addresses only, address ranges will not be accepted) EHD USE ONL!yl�l <br /> El Undergroun J Tank(UST) Street# Street Name city <br /> Cleanup Sit (LOP) tA <br /> FX1 Other clean in site(Non-LOP) 1 801 East Roth Road French Cam U CONSUMER <br /> Hazardous waste 0 <br /> Tiered Permtted Facility 2 815 East Roth Road n Cam NO 0 DAIRY <br /> Abovegrour Tank Pi <br /> P9 LIST (Monitoring I Removal) 3 837 PWS <br /> M Hazardous Materials East Roth Road <br /> El Spill I Relea!a Response lZ:riznrk ('-M )v 0 60 <br /> r]Solid Waste =acifity Y Vehicle 4 707 East Roth Road French Cam 9 , . N TERQUAL17Y <br /> F-1 Food Facility <br /> i­Rtoo COIN <br /> pooP/Spa <br /> F-I Dairy 6 11180 Vallejo Ct S French Cam LA f- [9"SITE WFIGAMCN <br /> Land Use ApAcation Sites ,ii01.qAi_ Nu &Xe <br /> Septic Pumper Truck/ 6 f N4Z�,S'N. <br /> Yard I Chemial Toilets <br /> Wastewater 7reatment Plant <br /> Housing Allatament 7 JgICUPA <br /> Motel/Hotel ASTIHM I HW <br /> Chicken Ranc i I Dog Kennel <br /> ® E3 CUPA <br /> Med1cal Waste Facility UST <br /> Tattoo/Body P arcing <br /> P9 Waste Tire SCUD WASTE <br /> N Compiaint <br /> F-1 Other(Please 'pacify): <br /> ACCOUNTING <br /> *BOXED AREA-EHD USE ONLY <br /> Pry RA <br /> L3 <br /> 2X_1 6 A, <br /> 0 Records provided by Staff-PPRComplete. Staff Name: t <br /> V ? EHD 48-{]6 <br /> 1868 E. Hazelton Avenue � Stockton, California 95205 1 T 209 468-3420 F 209 464-0138 I www.sjcehd.com <br /> I <br />