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From - n Fax:(888)828-2635 To: 12094640138@rcfax.cc Fax: +1209464013B Page 2 of 2 10212015 11:11 AM <br /> EHD LOG NUMBER <br /> RD^A u �vep SAN JOAf1UIN COUNTY <br /> "- ENVIRONMENTAL HEALTH DEPARTMENT <br /> • OCT 21 Z015 1868 East Hazelton Avenue, Stockton, CA 95205-6232 v <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sigov.org/ehd <br /> ENVIRONME�TALwEALiH f tlf Llt� ECORDS RELEASE APPLICATION <br /> P <br /> APPLICANT: Erik Brown SUSINESSIACsENCY: Partner ESI <br /> ADDRESS: <br /> 520 Shelly Drive CITYISTATEIZIP: Pleasant Hill, CA 94523 <br /> PHONE(1): (925)262-8101 PHONE (2): (925) 305-5337 FACSIMILE, (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 /> ❑ CHECK BOX TO EXPEDITE REQUEST. SH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE October 21, 2015 <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EMD USE ONLY <br /> Sheet# Street Name City _- unit 7 <br /> 1. 441 West MLI<Jr. Drive Stockton <br /> 2 ormer yay — — __ — [1 Unit z <br /> 3. es - - <br /> 4. nit 3 <br /> 5. � <br /> ►°lza <br /> • 5 [�'Unit 4 <br /> 7. <br /> B. _ 0 Unit 5 �.1-I <br /> 9. oriel I a 1,ul <br /> 10. <br /> Specific Date Range of Information Requested: From All to All <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FAcft r YNEHICLE <br /> X OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ®ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> ®HAZARDOUS WASTE/HAZARDOUS MATERIALS ❑MoTELIHOTEL ❑PUMPER TRUCK/YARDICHENUm TOILETS <br /> ®TIERED PERMITTED FACILITY ❑PooLISPA ❑ <br /> LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> List uo to ten addresses in the space above. Selaet the types)of fifes hom the list above by checking the appropriate <br /> i. <br /> box(es). At least one file type MUtca6onaere�efved atter 3:00 pfbe proc aessed thea ezf dicated Address <br /> businessday, <br /> ranges will not be accepted.Appl <br /> For assistance in idenfifying the nature and contenf of EHD records,phase contact EHD at the number noted above. <br /> 2. <br /> (t0) <br /> 3 days aftee trecelp of applwUon. The flies vrifl be held for s mazimu of ftve business days for review. Appointments <br /> should be scheduled accordingly. <br /> 4. Any file not returned En the same condhEon as released will be reorganized by EHD staK at Ehe expense of theapplicant <br /> Future file reviews by the same appllcard may require a 4130 deposit prior to review. XED AREA.EHD USE ONLY"P <br /> • <br /> ❑ Records provided by Staff-PPR Complete. Staff Name; <br /> 061 A4 <br /> END 4e H <br />