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R'om: Erik Brown E 1Fax:(88 828-2636 To: '12094640138Qrcfax.c Fax: (209)4r4-0138 Page 2 of 2 04/28/2017 9:03 AM <br /> R TE%i E: E� � EHD LOG NUMBER <br /> jL,-v� SAN JOAQUIN COUNTY <br /> AN 2 B 2011 �4 ENVIRONMENTAL HEALTH DEPARTMENT �&,rf SO <br /> ���PFrWA�ERVI ES_ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> N�ESQ elephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Erik Brown BUSINESSIAGENCY: Partner ESI <br /> ADDRESS: - 520 Shelly Drive CITYISTATEMP: Pleasant Hill,CA 94523 <br /> PHONE (1): (925)262-8101 PHONE(2): (925)305-5337 FACSIMILE: (888)828-2635 <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- SH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS /(p <br /> SIGNATURE OF APPLICANT DATE April 28, 2017 D <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> street g Street Name city ,.,� ,� El unit 1 <br /> 2. 3460 Nag\ee Rd ,Tracy � �/ L"w <br /> y� _- -_ -- <br /> 3. 5}4 Mt)lityA{jaN <br /> 4. _ nits. <br /> 5. CUPR`W`� A 7 <br /> 7. CupR-NS C <br /> 8. ' <br /> 9. <br /> 10. ❑Units <br /> specific Date Range of Information Requested: From All to All <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILRYNEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> ®UNDERGROUND TANK(MONfrORING/REMOYAL) ❑FOOD FACILITY ❑DAIRY <br /> ®ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> ®HA2ARDOUS WAsTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ®TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOO/BODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the type(s)of flies from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0136 or mall 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 END will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten(10) <br /> days after mcelpt 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 END staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$130 deposit prior to review. 'DOXED AREA-EHD USE ONLY"' <br /> "► l�-�,ItLJ. :2.^t -i-w .rd nxt T, rmyDciinA�?-- <br /> • <br /> ❑ Records provided by Staff-PPR Complete. staff Name: <br /> EHD 40-H OW1114 <br /> Received Time Apr. 28. 2017 8:59AM No. 1344 <br />