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SAN JOAQUINRECEIVED. <br /> ny ironmental Health Department <br /> " � 20i�� OUi�TY JAN nPUBLIC RECORDS RELEASE APPLICATION <br /> ENVIRON6AENfiALFfEAM <br /> PetiMFT/SERACES EHD LOG NUMBER: 87865 <br /> APPLICANT: ERIK BROWN BUSINESS/AGENCY: AEI CONSULTANTS <br /> ADDRESS: 520 SHELLY DR CITY/STATE/ZIP: PLEASANT HILL, CA 94523 <br /> PHONE (1): 925-262-8101 PHONE(2): 925-305-5337 FAX OR E-MAIL: 888-828-2635 <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 /> SIGNATURE OF APPLICANT PROCESSED BY STAFF, DOM M DATE JANUARY 23, 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 checking the appropriate box(es). At least one file type MUST be selected. Fax to (209)464-0138, mail to the <br /> address indicated below, or email to infoCEDsicehd.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 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 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 $152 deposit prior to review. I��a <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) 11 <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT ( p y g p <br /> FILES (Specific addresses only, address ranges will not be accepted) EHD USE ONLY <br /> ❑Underground Tank(UST)D Street# Street Name City <br /> Cleanup Site(LOP) Am �� to—,_ p fly ❑CONSUMER <br /> ❑Other Cleanup Site(Non`Oir16662 HWY 68 LOCKEFORD <br /> Zo <br /> ®Hazardous West�/1�� 7y 5 [3 DAIRY <br /> ®Tiered Permitted al; 2 <br /> ®Aboveground Tank <br /> ® UST (Monitoring/Removal) ❑PWS <br /> ®Hazardous Materials 9 <br /> ®Spill/Release Response <br /> F1 Solid Waste Facility I Vehicle 4 [j WATER QUALITY <br /> ❑Food Facility <br /> ❑Pool I Spa ❑SERE MnlaNilON <br /> ❑Dairy 6 <br /> ❑Land Use Application Sites <br /> ❑Septic Pumper Truck/ 6 [jHOUSING <br /> Yard/Chemical Toilets <br /> ❑Wastewater Treatment Plant, MCUPA <br /> ❑Housing Abatement 7 AST/HM/HW <br /> ❑Motel/Hotel <br /> ❑Chicken Ranch/Dog Kennel ®CUPA <br /> Medical Waste Fatality a DST <br /> ❑Tattoo/Body Piercing <br /> ❑SouO wasre <br /> ❑Waste Tire 9 <br /> ❑Complaint <br /> ❑Other(Please Specify): ❑ACCOUNTING <br /> 10 <br /> "*BOXED AREA-EHD USE ONLY*- <br /> 1/23/2018—CALLED APPLICANT. INFORMED THEM FILES ARE APPROVED FOR RELEASE,AND WE HAVE STARTED THE <br /> PRRA FOR THEM. DOM M <br /> 1.25-1 Qti n M <br /> r - PRC off Name: DAL Z ( EHD 48-06 <br /> 118 -2 I 1 ; a u9T F rtq 5QLA4P a f 8 •�-1g. Prov o✓� L0. <br /> 1868 E. Hazelton Avenue I Stockfon, California 95205 T 209 468-3420 1 F 209 460138 1 www.sjcehd.com P61 <br />