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RECEIVED <br /> SAN J OA Q U I N MAY 14 2018 Environmental Health Department <br /> --COUNTY PUBLIC RECORDS RELEASE APPLICATION <br /> (-yroatnP55 Cjro1�5 herr R /11 <br /> PTEMAIL {�,',//�]97 <br /> EHD LOG NUMBER. <br /> APPLICANT: Erik Brown BUSINESS/AGENCY:AEI Consultants <br /> ADDRESS: 520 Shelly Drive CITY/STATE/ZIP:Pleasant Hill,CA 94523 <br /> PHONE(1): 925-262-8101 PHONE(2): FAX OR E-MAIL: ERIK@MNM-ENV.COM <br /> submittal Please allow 10 business days from date of application 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 Erik Brown DATE 5/14/18 <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 infopsicehd 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. ��� <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES (Specific addresses only,address ranges will not be accepted) EHD USE ONLY <br /> XD Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP)• <br /> OX ///���Other Cleanup Site(Non-LOP) <br /> ' 2402 South California Street Stockton � E]CONSUMER <br /> NX Hazardous Waste <br /> Q Tiered Permitted Facility 2 ❑DAIRY <br /> I]X Aboveground Tank h'1 .�'1 Will, � l� <br /> Q UST (Monitoring/Removal) 3 PWS <br /> Q Hazardous Materials <br /> f IW�3 �,/vlX <br /> QX Spill/Release Response � <br /> ` _ 2 <br /> Solid Waste Facility/Vehicle 4 ��J���.3 ATER QUALITY <br /> ^� <br /> Food Facility <br /> Pool/Spa SITE MITIGATION <br /> Dairy 5 <br /> Land Use Application Sites <br /> Fx Septic Pumper Truck/ 6 HOUSING <br /> Yard/Chemical Toilets <br /> Fx Wastewater Treatment Plant <br /> Housing Abatement 7 CUPA <br /> Motel/Hotel AST/HM/HW <br /> Chicken Ranch/Dog Kennel CUPA <br /> Medical Waste Facility 8 UST <br /> Tattoo/Body Piercing <br /> Waste Tire 9 SOLID WASTE <br /> Complaint <br /> Other(Please Specify): 10 ❑AccouN TNG <br /> ***BOX`E�Ds AREA-EHD USE ONLY— <br /> El Records provided by Staff-PPR Complete. Staff Name: <br /> EHD 48.06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />