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SAN J OAQ U I NEEIVvironmental Health Department <br /> - COUNTY -- JUL 2 6 2018LIC RECORDS RELEASE APPLICATION <br /> ENVIRONMENTAL HEALTH' -1, 17 EHD LOG NUMBER: <br /> � <br /> APPLICANT: Janet Henkai " i ti t� BUSINESS/AGENCY: AEI Consultants <br /> ADDRESS: 520 3rd Street, Suite 209 CITY/STATE/ZIP: Oakland, CA/94607 <br /> PHONE (1): 408-559-7600 PHONE(2): FAX OR E-MAIL: nvaiighan aaironsiiltantc rnm <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 DATE July 26,2018 <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 info0sicehd.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. <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 all to <br /> ENVIRONMENTAL it <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES (Specific addresses only, address ranges will not be accepted) EHD USE ON L <br /> ® Underground Tank(UST) Street# Street Name City <br /> I' E]CONSUMER <br /> /� <br /> Cleanup Site(LOP) Newton Road (� <br /> ❑x Other Cleanup Site(Non-LOP) ' 4239 �,W Stockton ,fu <br /> • © Hazardous Waste5 Et ynj e'i41A, W El DAIRY <br /> x❑Tiered Permitted Facility 2 4301 Newton Road Stockton i lS ' <br /> F1 Aboveground Tank <br /> ® UST (Monitoring/Removal) ❑PWS <br /> 3 <br /> © Hazardous Materials <br /> ®Spill/Release Response <br /> ATER QUALITY <br /> Solid Waste Facility/Vehicle q <br /> Food Facility <br /> Pool/Spa N1115ITIE MITIGATION <br /> Dairy 5 <br /> Land Use Application Sites <br /> ®Septic Pumper Truck/ ouslNG <br /> 6 <br /> Yard I Chemical Toilets <br /> ®Wastewater Treatment Plant COPA <br /> Housing Abatement 7 AST I HM/HW <br /> ® Motel/Hotel <br /> Chicken Ranch/Dog Kennel UPA <br /> Medical Waste Facility S UST <br /> Tattoo/Body Piercing SOLID WASTE <br /> ®Waste Tire g <br /> ®Complaint <br /> F]Other(Please Specify): ❑ACCOUNTING <br /> 10 <br /> ***BOXED AREA-EHD USE ONLY <br /> / Fita <br /> 6— C <br /> ❑ Records provided by aff-PPR Complete. staff Name: EHD 48-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />