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RECEIVED <br />SAN JOA41IJUL 1? 2038 Environmet._.4I Health Department <br />-- C <br />_'N! T Y— PUBLIC RECORDS RELEASE APPLICATION <br />.: EMfItiQNl4fEllf ALi BY EMAIL � \ \ j 3 <br />P€f1MITISE#i � EHD LOG NUMBER: <br />APPLICANT: Adnan M. Angel BUSINESS/AGENCY: AEI Consultants <br />ADDRESS: 135 Riviera Drive #518 <br />CITY/STATE/ZIP: Los Gates/ CA / 95032 <br />PHONE (1): 831-331-3547 PHONE (2): FAX OR E-MAIL: <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 />SIGNATURE OF APPLICANT Adrian Angel w';'os;°i;'°'"°•."o.;.* DATE 7/17/18 <br />1. List up to ten addresses in the space below. Address ranges WILL NOT be accepted. Select the type(s) of files from the <br />list below by checking the appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-0138, mail to the <br />address indicated below, or email to info(a)sicehd.com. Applications received after 3:00 pm will be processed the next <br />business day. <br />2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted below. <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 $152 deposit prior to review. 2� <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) ' <br />Electronic Information: ❑x List ❑ Map— Description: <br />Specific Date Range of Information Requested: From Any to Any <br />ENVIRONMENTAL <br />FILE ADDRESS <br />HEALTH DEPARTMENT <br />FILES <br />(Specific addresses <br />only, address ranges will not <br />be accepted) <br />EHD USE ONLY <br />_ <br />❑x Underground Tank (UST) <br />Street # <br />Street Name <br />City <br />1 <br />16855 <br />South Harlan Road <br />Lathrop <br />^ .r ' L4 <br />L-t�t /'0v11.1J <br />Cleanup Site (LOP) <br />Q Other Cleanup Site (Non -LOP) <br />❑x Hazardous Waste <br />-1 Daev <br />11 <br />Q Tiered Permitted Facility <br />2 <br />n <br />(I 2_— 1/ <br />Q Aboveground Tank <br />G PWS <br />Q UST (Monitoring / Removal) <br />Q Hazardous Materials <br />3 <br />Q Spill / Release Response <br />0 ATEn Ganott <br />❑x Solid Waste Facility / Vehicle <br />4 <br />❑ Food Facility <br />[ISire MmeAnou <br />❑x Pool /spa <br />Q Dairy <br />5 <br />❑x Land Use Application Sites <br />p`Houswo <br />Q Septic Pumper Truck / <br />a <br />Yard / Chemical Toilets <br />O Wastewater Treatment Plant <br />COPA <br />rX Housing Abatement <br />r <br />AST/HM IHW <br />Q Motel/Hotel <br />[DICUPA <br />Chicken Ranch I Dog Kennel <br />Q Medical Waste Facility <br />B <br />UST <br />Taltca/Body Piercing <br />®souo WASTE <br />❑ Waste Tire <br />a <br />❑ Complaint <br />❑ AxWaneG <br />Other (Please Specify): <br />10 <br />***BOXED AREA - EHD USE ONLY*** <br />r. <br />❑ Records provided by Staff -PPR Complete. Staff Name: END 4846 <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sicehd.com <br />