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08/16/2012 09:42 4085597601 AEI SAN JOSE PAGE 01/01 <br />ro <br />ED <br />�rmD �/ locates at 1868 Hazelton (near county bid d'e'pt)- 512 <br />ACEIVED 9 012 <br />�00SAN JOAQUIN COUNTY EHD LOG NUMBER <br />�� 2012 ENVIRONMENTAL HEALTH DEPARTMENT <br />Attn:13 LINIAENTi� 600 East Main St. Stockton, CA 95202-3029 <br />(p 209.4W,,89 ERVi ��Le: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: RebeCCa BustoEs <br />ADDRESS: 3880 South Bascom Ave. suite 112 BUSINESS/AGENCY: AEI Consultants <br />CITY/STATEIZIP: San Jose, CA 95124 <br />PHONE(1): 408-559-7600 x2004 PHONE(2):650-922-7385 FACSIMILE: <br />TENTATIVE* APPOINTMENT DATE: _ <br />(Plenne allow 10 buslrresa days from date of appilcstlon submittal -'Tentative only - must e conflnnad) <br />❑ CHECK BOX TO EXPEDITE REpUES - St22 FEE (CASH OR CHECK ONLY) -REQUEST PROCESSED IN 3 <br />SIGNATURE OF APPLICANT <br />DATE <br />Electronic Information: ❑ List ❑ Map - Descrlption: <br />FILE ADDRESS Stmt Street Name <br />City <br />1. 213 South Kelly Street Lodi � z <br />2. 214 South Kelly Street Lodi I <br />3. I l c= <br />flCLIC lrcu I IMc nue. 1U. LUIL 7.1urllyl 11 U. U0UI <br />Y <br />DAYS <br />2. <br />4. Y. , <br />5• p Unit 31 <br />.6• II <br />. I ❑ Unit a <br />8. <br />—9. ❑ Unk 6 <br />10. I <br />SpecHic Date Range of Information R ❑ Uniti; Requested: From reCOr s on 1 e . m <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />,UNDERGROUND TANK (UST) CLEANUP SITE(LOP) <br />LOP <br />//) HOUSING ABATEMENT (SOLID WASTE FAtlLIjYNEHICLE <br />OTHER CLEANUP SITE (NON -LOP) <br />FOOD <br />UNDERGROUND TANK (MONITORINGIREMOvAL]I/— DOG KENNa FACILITY WASTE TIRE 5 /7 <br />HAZARDOUS WASTE GENERATOR -L- DAIRY _ I <br />TIERED PERMfTTED FACILITY C4'- CHICKEN RANCH WASTEWATER -?P FAT�MENT <br />POOL/SPA P - <br />TATTOO/BODY PIERCING MOTUSPATEL PUMPER TRUCK/YARD/CHEMICAL TOILETS <br />MEDICAL WASTE FACUTY OTHER (PLEASE SPECIFY) LAND USE APPLICATION SITES <br />WELL AND SEPTIC PERMIT RECORDS ARE AVA1LAnLE FOR REVIEW: MONDAY -FRIDAY $:00 AIVI-5:00Pu1(EXCLUDING HOLIDAYS) <br />1. Lift up toten addresses In the space above. Select the type(e) of flies from the list above b checkln the a <br />box(es). At least one fate type MUST be selected. Fp In <br />ax III _y g PDropriate <br />ranges will not be accepted - for additional assisfanft�ft1e addresses, co Intact the EHD. Applicatlonsbreceived afters <br />3:00 pm will 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 receipt 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 actfvefy being worked on by EHD staff may not be immediately available for review. A new application may be <br />submitted when the file is avallable. <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 $122 deposit prior to rpvIpw <br />