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08/16/2012 09:42 40`85597601 AEI SAN JOSE PAGE 01/01 <br /> RECEIVE =Y IocarT� at 18 68 Hazelton (near county bid de t -5/2 <br /> •0 DATE RECEIVED <br /> 9 p 012 <br /> 62SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ,u 1 2012 ENVIRONMENTAL HEALTH DEPARTMENT <br /> Attn: WWAENT��- � 6)0 East Main St, Stockton, CA 95202-3029 <br /> (p 209.46M ER e: (209 468-3420 Fax: (209) 464-0138 Web: www.Sigov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Rebecca Bustos <br /> ADDRESS: 3880 South Bascom Ave. Suite 112 BUSINESS/AGENCY: AEI Consultants <br /> CITY/STATE/ZIP: San Jose, CA 95124 <br /> PHONE(1): 408-559-7600 x2004 PHONE(2): 650-922-7385 FACSIMILE: <br /> TENTATIVE'APPOINTMENT DATE: <br /> (Pa483e allow 10 busirmms days from_dateof appllcstlon submlKal--renfat onry-m at be conflnmed) <br /> ❑CHECK BOX TO EXPEDITE REQUES -$122 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 B SINES$DAYS <br /> SIGNATURE OF APPLICANT DATE �` I(� 1,7- <br /> Electronic Information: ❑ List❑Map-Description: <br /> ` FILE ADDRESS E ONLY <br /> /1 Street Name city <br /> F37Kelly <br /> Kelly Street Lodi L ft1 <br /> Street Lodi• Unit 2 <br /> 4. <br /> 5. ❑unit e ;�(,- <br /> 6. <br /> 7. ❑Unit a <br /> 8. <br /> 9, (]unit s <br /> Spectnc Date ftenga of Information Requestod: From recor s on 1 e- ❑Unit 6 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES to <br /> ,UNDERGROUND TANK(UST)CLEANUP SITE(LOP) HOUSING ABATEMENT <br /> _N SOTHER CLEANUP SITE(NON-LOP) oot) Y LOUD WASTE FACILfJY/�IEHICLE <br /> UNDERGROUND TANK(MONITORING,(REMOVAI DWASTE TIRE 5 fj b <br /> �� OG KENNEL, ^W� <br /> HAZARDOUS WASTE GENERATOR 4, DAIRY a _ <br /> NJ TIERED PERMITTED FACILITY VOTEL N RANCH WASTEWATER I REATTMENT PLAd., <br /> TATTOO/BODY PIERCING MO POOL/SPA <br /> EL PUMPER TRUCKNARD/CHEMICAL TOILETS <br /> MEDICAL WASTE FACILITY OTHER PA LAND USE APPLICATION SITES <br /> OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVA1LAnLE FOR REv1Ew: MONDAY-FRIDAY 8:00 AM-5:00Pm(EXCLUDING HOLIDAYS) <br /> 1. List_up to ten addresses In thespace above. Select the types)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(2091464-0138 ora the agdress 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 files exist An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The flies will be held for a rnaxlmum 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 reorgani2ed by EHD staff at the expense Of the applicant. <br /> Future file reviews by the same applicant may require a$122 deposit prior to review. <br /> Eno USE ONLY <br /> -z 0S. i t4 <br /> EMD4f-0 <br /> 67r2G/10 <br /> Received Time Aug, 16. 2012 9: 38AM No. 0867 <br />