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f <br /> From.Ar=t Consultants 406 559 7601 03/2'x''013 OB:55 #OSa P.041/001 <br /> F <br /> EHD LOG NUMBER <br /> DAT NECFCEIVEC7 r`_ : i <br /> SAN JOAQUIN COUNTY <br /> v' ENVIRONMENTAL HEALTH DEPARTMENT <br /> MAS 21 ZQ,I3 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209) 464-0138 Web: www.sjgov.orglehd <br /> OERVIGES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Katie Hindt BUSINESSIAGENCY: AEY Consultants <br /> ADDRESS: 3880 S. Bascom Avenue, #112 CITYISTATE/ZIP- San Jose, CA 95124 <br /> PHONE(1): 831-295-9725 PHONE(2): 408-559-7600 FACSIMILE: 40B-559-7601 <br /> TENTATIVE"APPOINTMENT DATE: Time: <br /> (Please allow 1D business days from date of application submittal-'Tentative only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REaUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT khindtgaeiconsultant s.c DATE 3-22-13 <br /> Electronic Information: ❑ List❑ Map—Description:' <br /> FILE ADDRESS <br /> EHO USE ONLY <br /> Street 9 Street Name City 0 Unit 1 <br /> 1 757 E Eleventh racy <br /> 2. <br /> ❑Unit 2 <br /> S, (we reviewed records at your agency fo this site <br /> 4. in I)ecemb r 2011. it posse e, we wouid IaXe to <br /> 5. _KUn6. <br /> ft3 <br /> lo <br /> c Unit4 r� <br /> 7. �1 <br /> 8. <br /> Unit <br /> 9. <br /> 10. " <br /> 0 Unit6 <br /> Specific Date Range of Information Requested: From December 2011 to present <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ❑X UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> 0 UNDERGROUND TANK(MONITORING/REMOVAL) ❑Dor,KENNEL ❑DAIRY <br /> ®HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ®TIERED PERMITTED FACILITY ❑MOTELIHOTEL PUMPER TRUCKIYARD/CHEMICAL ToiLETS <br /> ❑TATTOO/BODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> I. 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. Fax to(2091464-0138 or mail to the address indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EMD. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. 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 /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may be <br /> submitted when the file is available. <br /> 4. Any file nofretumed 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$125 deposit prior to review. <br /> EHD USE ONLY ' <br /> EHO"-06 8!1!11 <br /> Received Time Mar- 22. 201.3 9: 54AM No. 2613 <br />