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p� 01/21/2015 12:28 9257466099 AEICONSULTANTS PAGE 01/01 <br /> 13 DATE RECEIVED EHD LOG NUMBER <br /> 1100 SAN JOAQUIN COUNTY <br /> 00 ENVIRONMENTAL HEALTH DEPARTMENT SC>1868 East Hazelton Avenue,.Stockton, CA 95205-6232 <br /> JAN 21 21gephone: (209) 468-3420 Fax. (209)464-0138 Web:www.sjgov.org/efid �J <br /> PUBLIC RECORDS RELEASE APPLICATIOM <br /> F nau n ��SS <br /> APPLICWTX§ Wda <br /> BUSINESS/AGENCY:AEI Consultants <br /> ADDRESS: 2500 Camino Diablo CITY/STATE/ZIP:Walnut Creek,CA 94597 <br /> PHONE(1): (925)746-6023 PHONE (2): (530)713-8036 FACSIMILE: 929 746-6099 <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 /> ❑ CHECK BOX TO EXPEDITE REQUEST-$130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT 7� DATE <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> F2. 9 <br /> et 9 Street Name City _ ❑Unit 1 <br /> Highway 99 North Stockton ( ) <br /> 4Highway 99 North Stocktonunit 2 <br /> -z7-t5 <br /> 4. - <br /> 6. Unit 3 <br /> 6. ` lC <br /> /p Unit 4 <br /> 7. <br /> 8. <br /> _. _ ❑Unit5 <br /> 9. <br /> 10. <br /> jUnit B <br /> Specific Date Range of Information Requested: From Earliest to Present <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILITYNEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> QG UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ©ABOVEGROUND TANK ❑CHICKEN RANCHI DOG KENNEL <br /> ®HAZARDOUS WASTEIHAZARDOUS MATERIALS WASTEWATER TREATMENT PLANT <br /> ❑MOTEUMOTEL ❑PUMPER TRUCK/YARDICHEMiCAL TOILETS <br /> El TIERED PERMITTED FACILITY ❑POOLISPA <br /> ElTATT00/BODY PIERCING �LAND USE APPLICATION SITES <br /> ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FGF.REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List un 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 W(209) or mail to the address indicated above Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance In Identifying the nature and content of EHD records,please contact EHD at the number noted above. <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$125 deposit prior to review. '"*BOXED AREA-EHD USE ONLYI," <br /> D Records provided by Staff-PPR Complete;Staff Name: <br /> Received Time—Jan. 21. -2.015-12;20PNFNo. 7932 A„a,,, <br />