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RECEIVED <br /> SAN J OA Q U I NG= 4 �d�1 Environmental Health Department <br /> •--- C O U N T Y PUBLIC RECORDS RELEASE APPLICATION <br /> Lreotness grows here-tNVIRONMENTALHEALTH <br /> PERMIT/SERVICES EHD LOG NUMBER. 7X' <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: mn '0 ei su <br /> Please allow 10 business days from date of application submittal for the records to be MbStaff will contact you to arrange an appointment date and time to review the requeste recs. <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(cilsicehd 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. f <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[I Map—Description: <br /> Specific Date Range of Information Requested: From ALL to ALL <br /> FENVIRONMENTAL FILE ADDRESS <br /> ALTH DEPARTMENTFILES (Specific addresses only,address ranges will not be accepted) EHD USE ONLY <br /> derground Tank(UST) Street# Street Name Cityeanup Site(LOP) <br /> 865 East Roth Road 0 ❑CONSUMER <br /> [�Other Cleanup Site(Non-LO French Camp � <br /> ®Hazardous Waste <br /> DAIRY <br /> Tiered Permitted Facility 2 865 Roth Road French Camp <br /> ®Aboveground Tank <br /> [�UST (Monitoring/Removal) S3 q pWs <br /> Hazardous Materials 3 889 Roth Road French Camp <br /> ®Spill/Release Response <br /> Q Solid Waste Facility/vehiic{p ( , 4 ATER QUALITY <br /> Food Facility1jn.•��}� <br /> Pool/Spa u / (nl// SITE MITIGATION <br /> ®Dairy 5 <br /> © Land Use Application Sites <br /> ®Septic Pumper Truck/ 6 ❑HOUSING <br /> Yard/Chemical Toilets <br /> ®Wastewater Treatment Plant UPA <br /> ❑Housing Abatement 7 AST/HM/HW <br /> Motel/Hotel <br /> E]Chicken Ranch/Dog Kennel UPA <br /> 8 <br /> ®Medical Waste Facility � UST <br /> Tattoo/Body Piercing <br /> D WASTE <br /> ®Waste Tire y SOLI <br /> ®Complaint <br /> Other(Please Specify): <br /> 10 ACCOUNTING <br /> ***BOXED AREA-EHD USE ONLY*** <br /> io <br /> e� <br /> 11f),`1 <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: EHD48-06_ <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 F 209 464-0138 www.sjcehd.com <br />