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07/16/2012 16:41 9257466099 AEI CONSULTANTS PAGE 01/01 <br /> •� <br /> ITECEIV'Eu <br /> locate . ... 1865 Hazelton (near county bldg dsp,, 5I2012 EHD LOG NUMBER <br /> DATE RECEIVED SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL WEALTH DEPARTMENT <br /> Atte: N05 <br /> MENTAL HEALTH <br /> 600 East Main St. Stockton, CA 95202-3029 r <br /> RViphone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/E:hd <br /> 09.4(p 26 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPI_ICANT:_jy117�'--� .f",Z'n BUSINESSIAGENCY: A-f-/ C:��ryG rx <br /> ADDRESS; <br /> 2500 Camino Diablo CITYISTATEIZIP:Walnut Creek, CA 94597 <br /> PHONE(1): PHONE(2): FACSIMILE:_9 2s -7q(a _(&P99 <br /> TENTATIVE'APPOINTMENT DATE: Time:_. <br /> (Pleaso allow 10 business days from date of application submittal-'Tentative only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQU ST-$122 FEE N OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE_ 7-1 I <br /> Electronic Information: List[] Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City Unit 1 <br /> 2. <br /> i I I �[)Unit 2 <br /> 3 /7 �� 4 <br /> [7. <br /> ( lr( r1'�,r_( Cli I l ( � f Unit 3 <br /> r y. <br /> El <br /> _ ' Unitd <br /> \r\ <br /> ,®Q —- rE]Unit 6 <br /> '� Ali records on -i- .eft <br /> Specific Date Range of Information Requested: From � — �- <br /> # ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 0 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) - o WING ABATEMFNT SOC io WASTE FACiLI HICLE�I j 1 l— <br /> OTHERCLEANUP SITE(NON LOP) FOODu FACILITY - /WIWASTETIRE (� ��P�I��l/ `t 1 <br /> "rrnt,' DAIRY <br /> f+j a UNDERGROUN9 TANK(MONITORINGIREMOVAL) t1 DOG KENNEL rI� <br /> d HA7ARDOUS WASTE GENERATOR 14 CHICKEN RANCH s rt�rWAST ENIATERTREATMENT PLANT <br /> S TIERED PERMITTED FACILITY( <br /> 2'MOTELIHOTEL �I�PUMPERfRuCK1YARDICHEMICALT01LET5 <br /> . ] <br /> TATTOO/BODY PIERCING �,A1 POOLISPA LAND USE APPLICATION SITES <br /> bo MEDICAL WASTE FACILITY J OTHER(PLEASE SPEC(FY) <br /> �? WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:ODPnn(EXCLUDING HOLIDAYS) <br /> (� 1. List WD to ten ddresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> A (J box(es). At least one file type MUST be selected. Fax to(209)464-01$a or mail to the addres die a above Address <br /> 1O` 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 /> t..12. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten(10) <br /> l days after receipt of application. The files will behold 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 not returned In the same condition as released will be reorganized by EHD staff at the expense of the applicant. <br /> 3 c Future file reviews by the same applicant may require a$122 deposit prior to review. <br /> EWD use ONLY <br /> �Tll t Z , 0)& 11), Cn, <br /> In" <br /> Received- Time Jul. 16. 2012 4:44PM No, 0563 <br />