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RECEIVE - <br />DATE Rffft 9 2011 0 SAN JOAQUIN COUNTY NIS EHD LOG NUMBER <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />MMNONMEWRL H59d..T� 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Fl!1lTlSCH.,E' elephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd 9515qq <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: Demetri Rhos BUSINESSIAGENCY: AKF Holdings LLC <br />ADDRESS: 1463 Moffat Blvd CITYISTATEIZIP: Manteca, CA, 95336 <br />PHONE (1): 209-823-3121 PHONE (2):_0Zq FAX OR E-MAIL: j i��DSQi�IcV�+ o_ ape �vn,� 1 <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 />Q CHECK BOX TO EXPEDITE REQUEST- $139 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT DATE <br />1. List up to ten addresses in the space below. Select the type(s) of files from the list below by checking the appropriate <br />box(es). At least one file type MUST be selected. Fax to (209) 464-0138 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 $139 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 ❑ Map — Description: <br />Specific Date Range of Information Requested: From (CA It U toL-t— <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />LES <br />'UNDERGROUND <br />FILE ADDRESS <br />EHD USE ONLY <br />m(. TANK (UST) <br />Street # <br />Street Name <br />city <br />1 <br />18800 <br />South Spreckels Ave <br />Manteca <br />❑ CONSUMER <br />• , CLEANUP SITE (LOP) <br />OTHER CLEANUP SITE (NON -LO <br />.� HAZARDOUS WASTE <br />TIERED PERMITTED FACILITY <br />2 <br />E] DAIRY <br />ABOVEGROUND TANK <br />1132 <br />Norman Drive <br />Manteca <br />' <br />407 <br />AY � <br />J keis:A70 r <br />Manteca <br />J // E] PWS <br />KUST (MONITORING/REMOVAL)s�et�1( <br />9HAZAR000S MATERIALS <br />SPILL/RELEASE RESPONSE <br />SOLID WASTE FACILITY / VEHICLE <br />FOOD FACILITY <br />4 <br />WATER QUALITY <br />POOL / SPA <br />Fj SITE MI11GAMON <br />❑ DAIRY <br />S <br />IV LAND USE APPLICATION SITES <br />6 <br />HOUSING <br />F1 SEPTIC PUMPER TRUCK / <br />YARD / CHEMICAL TOILETS <br />1gWASTEVJATER TREATMENT PLANT <br />F] HOUSING ABATEMENT <br />MoTEUHOTEL <br />T <br />CUPA <br />CHICKEN RANCH / DOG KENNEL <br />MEDICAL WASTE FACILITY <br />8 <br />CUPA- UST <br />E] TATTOO/BODY PIERCING <br />WASTE TIREn <br />COMPLAINT <br />` <br />j Lj sOLIO WASTE <br />E] OTHER(PLEASE SPECIFY): <br />1B <br />^ • [j Accourmhb <br />,(��J•tl' <br />—BOXED AREA - EHD USE ONLY" <br />/l <br />❑ Records provided by Staff -PPR Complete. Seam Name: <br />EHD 48-06 _ <br />/ <br />