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i� 04/23/2015 13:59 9257466 AEICONSULTANTS EHD LOG NUMBER <br /> PAGE el/01 <br /> Tt EDPti SAN JOAQUIN COUNTY <br /> ■ ENVIRONMENTAL HEALTH DEPARTMENT <br /> ■ SPR 2 3 2Q15 1868 East Hazelton Avenue, Stockton, CA 95205-6232 �j h <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.orglehd \/ <br /> ENVIPEO MITISERVIC SLTPf <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Jordan Vida BUSINESS/AGENCY:AEI Consultants <br /> ADDRESS: 2500 Camino Diablo CITYISTATEIZIP:Walnut Creek, CA <br /> PHONE (1): 925-746.6023 PHONE (2): FACSIMILE:92S-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-$13OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT / DATE1 5 <br /> Electronic Information: ❑ List ❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street 9 Street Name - City <br /> 1. 11160 Vallejo Court French CampQ t uX00 �5 <br /> 2. _. yyr,,t ma- "'Cri ❑UnR 2 <br /> 3. - <br /> 4. <br /> --5 ,d Unit 3 <br /> 6. <br /> .✓[j UnIt4 <br /> -7. <br /> Unit 5 <br /> 10. <br /> Unit 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILETS <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ®SOLID WASTE FACILITYNEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ®WASTETfRE <br /> ®UNDERGROUND TANK(MONITORINc1REMOVAL) ❑FOOD FACILITY <br /> ® [_1 DAIRY <br /> ABOVEGROUND TANK ❑CHICKEN RANCH(DOG KENNEL <br /> ® ❑WASTEWATER TREATMENT PLANT <br /> HAZARDOUS WASTEIHAZARDOUS MATERIALS <br /> ❑MOTELMOTEL Ll PUMPER TRUCKIYARDICHEMICALTOILETS <br /> ®TIERED PERMTRED FACILITY 1❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOOIBOOY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-S:oOPM (EXCLUDING HOLIDAYS) <br /> 1. )_Ist up to ten 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(208)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 EHD at the number noted above. <br /> 3- The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ton(10) <br /> days after 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 retumed in the same condltion as released will be reorganized by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may requirer+a$125 deposit prior to review. "'BOXED AREA.EHD USE ONLY" <br /> ��s�(" �.I9(b"II . <br /> I AoadtR 4�T �I r_t lIV6 7 Ilra(te$C4. +Its C,Ca, <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> Received Time_Apr. 21 -2015— 1 : 58PNr'No. 8580 42814 <br />