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° HeaUth Department <br /> SAN , UA ~i �� yb —nvwronment=U <br /> -- C[ UNTY � <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> °�� <br /> � �� <br /> ~ ~~~~^^~~ ^^~~E~ EHDLOG NU08BEF�: ����C1���� � w�= <br /> APPLICANT: Natalie Vaughan BUSINESS/AGENCY: AE1 Consultants <br /> ADDRESS: 3880 S Bascom Ave, Suite 109 CITY/STATE/ZIP: Oakland, CA 94607 <br /> PHONE (1): 408-550-7600 PHONE (2): 925-922-4900 FAXORE-MAIL: n,aiiqhqna;;P*rnngiiltant.;rom <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrpn e an appointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT <br /> 1. List upto ten addresses inthe space below. /Vdmooranges WILL NOT hnaccepted. Select the typo(o)vffiles from the <br /> list below uychecking the appropriate box<oo>. Atleast one file type MUST boselected. Fax to(209)464-0138, mail to the <br /> address indicated below,or email to info(cDsicehd.com. Applications received after 3:8Opmwill beprocessed 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 /> u. The EHDwill notify the applicant ifany EHDfiles exist. Anappointment for review will boconfirmed approximately ten(1O) <br /> days after receipt ofapplication. T <br /> hnfi|oovi||bohw|dfpromaximumoffivobd fointments <br /> 4. Any�|onot returned inthe same nondibnnuum|oaoodviUbomorgunizodbyEufDj � hoWN nohoapp|ioon <br /> t'shou|dboaohodu|odaoourdin8|y. � — ' <br /> / <br /> Future file reviews by the same applicant may require a$152 deposit prior to review. 4: <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:O0AM'S:0OPM(EXCLUDING HOLIDAYS) <br /> Electronic information: El List E Map—Description: <br /> Specific Date Range of Information Requested: From all to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES (Specific addresses only,address ranges will not be accepted) EHD USE ONLY <br /> M Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) 771 East Roth Road French Camr LI CONSUMER <br /> FXJ Other Cleanup Site(Non-LOP) <br /> Hazardous Waste DAIRY <br /> Tiered Permitted Facility 783 East Roth Road French Camp <br /> Aboveground Tank <br /> Hazardous Materials East Roth Road <br /> [XI Spill/Release Response French Cami: <br /> Solid Waste Facility/Vehicle 4 791 East Roth Road French Cam[ <br /> r-1 Food Facility <br /> Dairy ?�,.,795 East Roth Road French Camp <br /> Land Use Application Sites <br /> Yard/Chemical Toilets <br /> Wastewater Treatment Plant EiTCUPA <br /> F-]Housing Abatement 7 AST I HM/HW <br /> P9 Motel/Hotel <br /> F1 Chicken Ranch/Dog Kennel to"CUPA <br /> UST <br /> n Medical Waste Facility <br /> Tattoo/Body Piercing SOLID WAS E <br /> Waste Tire 9 <br /> Complaint <br /> Other(Please Specify): AccouN-rING <br /> 10 <br /> —BOXED AREA-EHD USE ONLY <br /> ' <br /> 0 Records provided by Staff-PPR Complete. Staff Name: EHD 48-06 <br />