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buhlvu <br /> ��u SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> JUL <br /> 16 ,�� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (249)468-3420 Fax: (209)464-0138 Web:www.sicehd.com Email: info s`cehd.com <br /> VNVMNAII HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> —PEiM iw <br /> r..,kPPLICANT: MEGAN NOLET BUSINESS/AGENCY: AEI CONSULTANTS <br /> ADDRESS: 3880 S BASCOM AVE, STE 109 CITY/STATE/ZIP: SAN JOSE, CA 95124 <br /> PHONE (1): 408-559-7600 PHONE(2): 408-559-7601 FAX OR E-MAIL: MNOLET AEICONSULTANTS.COM <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-$152 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT PROCESSED VIA EMAIL BY STAFF. DOM M DATE JULY 21, 2017 <br /> 1. List up to ten addresses in the space below. Address ranges will not be accepted. Select the types) of files from the list <br /> below by checking the appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138, mail to the <br /> address indicated above or email to info(Dsicehd com Applications received after 3:00 pm will be processed the next <br /> 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 ten (10) <br /> days after receipt of application. The files 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 reorganized by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a $139 deposit prior to review. 1 <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:0QPM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map— Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS 1 u yT <br /> HEALTH DEPARTMENT <br /> FILES (Specific addresses only,address ranges will not be accepted) EHD USE ONLY <br /> Z UNDERGROUND TANK(UST) Street# Street Name ity <br /> CLEANUP SITE(LOP) /I tf� ❑CousuNER <br /> 17740 SHIDELER PKWY • }ROP f J/J� <br /> OTHER CLEANUP SITE(NON-LOP) ,.f 0 ./1��j1� <br /> HAZARDOUS WASTE /n �,"+J� (,�i/ />^/I Q DAIRY <br /> ®TIERED PERMITTED FACILITY 2427 YOSEMITE AVE LATHROP Aj0i� <br /> Z ABOVEGROUND TANK <br /> 2 UST (MONITORING/REMOVAL) PWS <br /> Z HAZARDOUS MATERIALS <br /> SPILURELEASE RESPONSE <br /> SOLID WASTE FACILITY/VEHICLE 4 WATER QUALITY <br /> FOOD FACILITY <br /> ❑POOL I SPA ]ZI SITE MITIGATION <br /> ®DAIRY 8 <br /> LAND USE APPLICATION SITES _ <br /> ®SEPTIC PUMPER TRUCK 1 6 ®HOUSING <br /> YARD I CHEMICAL TOILETS <br /> ®WASTEWATER TREATMENT PLANT CUPA <br /> HOUSING ABATEMENT 7 }tp/I 4,i <br /> �I MOTEUHOTFL A+5 <br /> CHICKEN RANCH I DOG KENNEL 10 CUPA-UST <br /> 8 <br /> ®MEDICAL WASTE FACILITY <br /> Ej TATTOOIBODY PIERCING <br /> WASTE TIRE SOLI!)WASTE <br /> 9 <br /> COMPLAINT <br /> OTHER(PLEASE SPECIFY)' ACCOUNTING <br /> 10 <br /> `r <br /> ***BOXED AREA-EHD USE ONLY <br /> 7/2112017—EMAILED APP TO REVISE REQ,OR BATCH PROCESSING IS NEEDED FOR THE 22 REQ ADDRS.APP WILL DO <br /> BATCH PROCESSIN . DOM M iy-)Lt5- 1, rp;�rti c'tx. „ter H,t Pte} bc._ <br /> 3 OF 3 Gi/ U2 02�r <br /> ❑ Records ,provided by Staff-PPR Complete. staff Name: <br /> EHD 48-06 <br />