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NP,E C EE�V E D FILE COPY <br /> SAN J OA Q U I N . ; , � Envor onnnenia� Health) Department <br /> -C O U N T Y— PUBLIC RECORDS RELEASE APPLICATION <br /> Greatness gravis here-ENVIRONMENTAL HEALTH to <br /> PERMIT/SERVICES EHD <br /> LOG NUMBER. 1*7X1.7 <br /> APPLICANT: Megan Nolet BUSINESS/AGENCY: AEI Consultants <br /> ADDRESS: 3880 S. Bascom Ave, Suite 109 CITY/STATE/ZIP: San Jose, CA 95124 <br /> PHONE(1): (408) 559-7600 PHONE(2): FAX OR E-MAIL: mnolet@aeiconsultants.com <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 Megan Nolet DATE 10/4/2017 <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 info(a)slcehd 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 ALL to ALL <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT <br /> FILES (Specific addresses only,address ranges will not be accepted) EHD USE ONLY <br /> ®Underground Tank(UST) Street# Street Name <br /> City <br /> Cleanup Site(LOP) <br /> Other Cleanup Site(Non-LO 865 East Roth Road E]CONSUMER <br /> French Campi <br /> ®Hazardous Waste <br /> RY <br /> [�Tiered Permitted Facility 2 865 Roth Road French Camp r DAI <br /> ®Aboveground Tank <br /> UST (Monitoring/Removal) pee 5j q ❑PWS <br /> [ Hazardous Materials 3 ggg Roth Road French Camp <br /> ®Spill/Release Response <br /> XD Solid Waste Facility/Vehic� ` ' 4 ATER QUALITY <br /> Food Facility <br /> Pool/Spa SITE MITIGATION <br /> ®Dairy 5 <br /> ©Land Use Application Sites <br /> ®Septic Pumper Truck/ 6 ❑HOUSING <br /> Yard/Chemical Toilets <br /> ®Wastewater Treatment PlantUPA <br /> Housing Abatement � AST I HM/HW <br /> Motel/Hotel <br /> Chicken Ranch/Dog Kennel UPA <br /> F7 <br /> I <br /> ®Medical Waste Facility UST <br /> ❑Tattoo/Body Piercing <br /> ®Waste Tlre 8 SOLID WASTE <br /> ®Complaint <br /> ❑Other(Please Specify): <br /> 10 ❑ACCOUNTING <br /> ***BOXED AREA-EHD USE ONLY*** <br /> V I—'Fl�'u��a` d�rn � 0+ f:7^L - C..<:.r �- E�yn r� ✓''+ �}- ' Gtt�e't lti'toi ��tlj'k. <br /> c <br /> ❑ Records provided by Staff-PPR Complete. staff Name: EHD48-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />