Laserfiche WebLink
67/19/2611 16:18 4085597601 AEI SAN JOSE PAGE 02/02 <br />EHQ LOG NUMBER <br />Vim T ► SAN JOAQUIN COUNTY <br />!E l 9 all ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main St. Stockton, CA 95202-3029 <br />EN\jj1R0,�NkENTALHEAL-fflephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />PE #SERVICES PUBLIC RECORDS RELEASE APPLICATION <br />M�' <br />APPLICANT: Katie Hindt <br />BUSINESS/AGENCY: AE7 Consultants <br />ADDRESS: 3880 S • Bascom Ave, #108 CITY/STATE/ZIP: <br />San Jose, CA 95124 <br />PHONE(1): 831-295-9725 PHONE (2): FACSIMILE: 408-559-7601 <br />TENTATIVE* APPOINTMENT DATE: Time: <br />(Please allow 10 bulness days from dabs of application submittal-'Tentarlre only - must be confirmed) <br />❑ CHECK BOX TO EXPEDITE <br />SIGNATURE OF APPLICANT <br />-$1 <br />FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />khindt@aeiconsultants -comDATE 7-19-11 <br />Electronic Information: ❑ List ❑ Map— Description: <br />Specific fate Range of Information Requested: From to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES \✓' <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FAaLITYNEHICLE �J <br />OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY ❑ WASTE TIRE <br />L UNDERGROUND TANK (MONITORINWREMOVAL)d` ❑ DOG KENNEL ❑ DAIRY <br />HAiARDOUS WASTE GENERATOR A ❑ CHICKEN RANCH ❑ WASTEWATER TREATMENT PLANT <br />TIERED PERMITTED FACILITY C7-- ❑ MOTELIHOTEL ❑ PUMPER TRUCKNARD/CHEMICAL TOILETS <br />❑ TATTOOIBODY PIERCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br />❑ MEDICAL WASTE FACILITY ❑ OTHER (PLEASE SPECIFY) <br />WELL. AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:00PNI(UCLUDING HOL2=11 <br />1. List unto ten addresses in the apace 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_( 1464-0138 or m it to the address indicated ybove._ Address <br />ranges will not be accepted - for additional assistance with file addresses, contact the FHD. Applications received after <br />3:00 pm wilt 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 rBoalpt 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 EH117 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 reorganised by EHD staff at the expense of the applicant. <br />Future file reviews by the same applicant may require a $122 deposit prior to review. <br />