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RSkGEIVE EHD LOG NUMBER <br /> - !� SAN AJOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT C2 •� <br /> Rti"1 ) 2(11P' 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sicehd.com Email: info@sicehd.com <br /> ENVIRONMENTAL TH <br /> REMwISEFInCE.4% PUBLIC RECORDS RELEASE APPLICATION <br /> �PPLICANT: Tyler Patel BUSINESS/AGENCY: AEI Consultants <br /> DDRESS: 520 Third St,Ste 209 CITY/STATE/ZIP: Oakland,CA 94607 <br /> PHONE (1): 510-907-3145 x2114 PHONE(2): 858-776-4974 FAX OR E-MAIL: 510-338-3192 <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-$139 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT Processed by Staff from email. Dom M DATE April 14 2017 <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 list <br /> 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 above, or email to infona 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 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. /Zl l <br /> Future file reviews by the same applicant may require a$139 deposit prior to review. LAl <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:o0PM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT ( ponly, 9 p <br /> FILES S ecific addresses address ranges will not be accepted) EHD USE ONLY <br /> ®UNDERGROUND TANK(UST) Street# Street Name city <br /> CLEANUP SITE(LOP) 0 CONSUMER <br /> 2533 W Kettleman Ln Lodi Vkfyl /VL <br /> OTHER CLEANUP SITE(NON-LOP) <br /> ®HAZARDOUS WASTE <br /> DAIRY <br /> ®TIERED PERMITTED FACILITY 2 2715 W Kettleman Ln Lodi/ ICO®ABOVEGROUND TANK CO <br /> ®UST (MONITORING/REMOVAL) ❑PWS <br /> ®HAZARDOUS MATERIALS 3 2745 W Kettleman Ln Lodi II II'Ir'r / / vt,/ <br /> ®SPILURELEASE RESPONSE V�Vr,1 IIII' r rlVrr' vV <br /> SOLID WASTE FACILITY/VEHICLE a 1379 S Lower Sacramento Rd Lodi ®WATER QUALM <br /> E]FOOD FACIE" <br /> ❑POOL/SPA ®SUN MITIGATION <br /> E]DNRY 6 1387 S Lower Sacramento Rd Lodi <br /> LAND USE APPLICATION SITES <br /> SEPTIC PUMPER TRUCK/ 6 11 HOUSING <br /> YARD/CHEMICAL TOILETS <br /> WASTEWATERTREATMENT PLANT ®CUPA <br /> I1 HOUSING ABATEMENT 7 <br /> MOTEL/HOTEL '�V�yn1 U•{ r.�J� <br /> CHICKEN RANCH/DOG KENNEL ®CUPA-UST <br /> 8 <br /> MEDICAL WASTE FACILITY <br /> TATTOO/BODY PIERCING <br /> ❑SOLID WASTE <br /> WASTE TIRE <br /> 9 <br /> ®COMPLAINT <br /> ®OTHER(PLEASE SPECIFY): ACCOUNTING <br /> Septic&Well permits 10 <br /> —BOXED AREA-EHD USE ONLY— <br /> LEI <br /> NLY"' <br /> ❑ Records provided by Staff-PPR Complete. staff Name: <br />