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r 07/16/2012 16:41 9257466099 AEI CONSULTANTS <br /> RECEIVED PAGE 01/01 <br /> locate*1868 Hazelton (near county bldg de*5/2012 <br /> DATE RECEIVED EHD LOG NUMBER <br /> .li II. 16 2012 SAN .JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT `. <br /> Attn: MENTAL HEALTH 600 East Main St. Stockton, CA 95202-3029 <br /> (p 209 46 7 8€pV( phone: (209)468-3420 Fax: (209)464-0138 Web: wvvw.sjgov.org/ehd <br /> �) PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: �Ql� Jailor BUSINESSIAGENCY: A,Fl (�Nry�7tFrv� <br /> ADDRESS: 2500 Camino Diablo CITYISTATEIZIP:Walnut Creek, CA 94597 <br /> PHONE(1): 925,"7q4v-1a0S3 PHONE (2): FACSIMILE:_,92s-74(0-(0099 <br /> TENTATIVE-APPOINTMENT DATE: 7.2- s. l2- Time: l I=oo� <br /> (P(easo allow 10 business days from date of application submittal- Tenlative only•must be con0rmed) <br /> ❑CHECK BOX TO EXPEDITE RE QU ST-$122F F H OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 7-Ifo- <br /> Electronic Information: ❑ List❑Map—Description: <br /> . FILE ADDRESS EHD USE ONLY <br /> Street# _ Street Name city Unit t <br /> Ly/ 1 12 9 C'r� a n I SIti ea �( <br /> lf2. <br /> Foe l�l�n u <br /> ' 2t t( (ZW <br /> J0 Un"t2 <br /> ui II4 ! iCt. t <br /> ( L� f c Unita 't"J <br /> 5. iI NC J C 0 d' <br /> 6. <br /> f 7. unit 6 <br /> O bo B. <br /> o V <br /> Unit 6 <br /> Specific Dete Range of Information Requested: FromA recon s <br /> ENVIRONM NTAL HEALTH DEPARTMENT FILES <br /> (J#ITATTOO/BODYPIERCING <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) OLISMG ABATEMENT -SSO ID WASTE FACIL HICLE�`/�� „ <br /> V\ THER CLEANUP SITE(NON•LOP) F00o FACILFACIL—e WASTETIRE (fj 1�/���/2]s,/�(X tcllt <br /> Fl CNDERGROUND TANK(MONITORINGIREMOVAL) oG 'DOGKENNEL DAIRY 3�j- }� ?'Z3—IZ <br /> c� AZARDOUS WASTE GENERATOR CHICKEN RANCH WASTEWATERTREATMEIVT PLANT <br /> IERED PERMITTED FACILITY p( MOTEUHOTEL ��PUMPER 7RUCKIYARDJCNEMICALTOILETS <br /> POOLISPA ®-LAND USE APPLICATION SITES <br /> Qo [i�' MEDICAL WASTE FACILITY OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM•6:DOPM(EXCLUDING HOLIDAYS) <br /> tY1. List un to tan a <br /> Cidiresses.in the space above. Select the type(s)of riles from the list above by checking the appropriate <br /> O CJ box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to,the address indicated above Address <br /> Oa If ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after <br /> V'JI 3:00 pmwin be processed the next business day. <br /> t12, 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 maximum of five business days for review. Appointments <br /> -� a, should be scheduled accordingly. <br /> v3 y 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 /> I— 4. Any file not retumeci In the same condition as released will be reorganized by EHD staff at the expense of the applicant. <br /> c Futuro file reviews by the same applicant may require a$122 deposit prior to review. <br /> NW EM USE ONLY` <br /> 1 fl m <br /> l I Z v <br /> s o <br /> Received' Time Jul, 16, 2012 4:44PM No. 0563 -j-24-IZ' rOv; lirart WP EIC `or <br />