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09/12/2011 11:16 9257466099 <br />ENEu <br />DATE RECEIVED <br />AEI CONSULTANTS <br />SAN IOAGiUIN COUNTY <br />PAGE 01/01 <br />EHD LOG NUMBER <br />"!` 1) Z011 <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />Attn� MENTALj§EALTH 600 mast Main St. Stockton, CA 95202-3029 % \ <br />(R 209 �F�VI $phone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />PUBLIC RECORDS RELEASE APPLICATION <br />O�- <br />APPLICANT: Corey Gargano <br />ADDRE=SS: 2500 Camino Diablo <br />BUSINESS/AGENCY:AEI Consultants <br />CITY/STATEIZIP: Walnut Creek, CA, 94597 <br />PHONE(l)-. <br />925-746-6046 PHONE (2): _ FACSIMILE: 925.746-6099 <br />TENTATIVE" APPOINTMENT DATE' _ Time: <br />(Please allow 10 business days from da appllration submittil-'Tentaffve only - must be confirmed) <br />❑ CHECK BOX TO EXPEDITE REQUEST - 2FEE S CHECK ONLY) - REQUEST PROCESSED IN 3 BUSIINE5S DAYS <br />SIGNATURE OF APPLICANT DATE <br />Electronic Information: <br />[] List ❑ Map — DesC ipt <br />Specific Dat® Range of Information Requested: rom <br />to <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) <br />ENVIRONMIPOOLISPA <br />I HEALTH DEPARTMENT RILES <br />HOUSING ABATEMENT <br />�7 <br />SOLID WASTE FACILITYNEHICLE <br />OTHER CLEANUP SITE (NDN -DOD) <br />FILE ADDRESS <br />WASTE TIRE <br />n <br />EHD USE ONLY <br />Unit 1 <br />DAIRY nt p <br />WASTEWAIFER TREATMENT PLANT - <br />Street # <br />Street Name <br />City <br />1 <br />1514 <br />Mar <br />et Street <br />stoc toxo <br />u�.� � <br />r �9 cqr,? <br />;?<.t2 <br />2. <br />;5 CG <br />Stockton <br />3. <br />Stockton <br />Unita <br />Stockton <br />5. <br />102 S. <br />Wilson Way <br />Stockton <br />Mcubr <br />€ +. g <br />"J') GW'�, U a <br />Unit 4 <br />6.7 <br />7. <br />u 5 <br />o <br />!� to 1 0'Unit5 <br />gY <br />i /) �� <br />10 <br />1. List up_to ten addresses in the space above. Select the type(s) of files from the list above by checking the appropriate <br />box(es). At least one file type MUST be selected. Fa q9) 464 -0138 -gr mzW to the a0gress indicated_ above. Address <br />ranges will not be accepted - for additional assistance with file addresses, contact the EHD. Applications received after <br />3:00 pm will be processed the next business day. <br />2. The FHD 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 />3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new appllcation may be <br />submitted when the file is available. <br />4. Any flle 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 $122 deposit prior to review. <br />I , _ __ EHD USE ONLY <br />' IIa <br />I�Ff <br />Specific Dat® Range of Information Requested: rom <br />to <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) <br />ENVIRONMIPOOLISPA <br />I HEALTH DEPARTMENT RILES <br />HOUSING ABATEMENT <br />�7 <br />SOLID WASTE FACILITYNEHICLE <br />OTHER CLEANUP SITE (NDN -DOD) <br />FOOD FACILITY <br />WASTE TIRE <br />n <br />UNDERGROUND TANK (MONITORINGIREMOVAL) <br />HAZARDOUS WASTE GENERATOR <br />DOG KENNEL <br />CHICKEN RANCH <br />DAIRY nt p <br />WASTEWAIFER TREATMENT PLANT - <br />TIERED PERMITTED FACILITY <br />MOTELIHOTEL <br />PUMPER TRUCKIYARDICHEMICAL TOILETS <br />TATTOO/BODY PIERCING <br />LAND USE APPLICATION SITES <br />MEDICAL WASTE FACILITY <br />OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) <br />1. List up_to ten addresses in the space above. Select the type(s) of files from the list above by checking the appropriate <br />box(es). At least one file type MUST be selected. Fa q9) 464 -0138 -gr mzW to the a0gress indicated_ above. Address <br />ranges will not be accepted - for additional assistance with file addresses, contact the EHD. Applications received after <br />3:00 pm will be processed the next business day. <br />2. The FHD 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 />3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new appllcation may be <br />submitted when the file is available. <br />4. Any flle 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 $122 deposit prior to review. <br />I , _ __ EHD USE ONLY <br />' IIa <br />I�Ff <br />EHD 48.06 ' /fJ�n6c� nh pr S� <br />©I /� „- d &4 <br />