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s A N J OA Q U I N RECEIVEDronmental Health Department <br /> p ent <br /> C 0 U N T Y -- PUBLIJ RECORDS RELEASE APPLICATION <br /> F-WRONMIENTALHffMM EHD LOG NUMBER:?;il7a7 <br /> APPLICANT: Elizabeth SCuderO BUSINESS/AGENCY: AEI Consultants <br /> ADDRESS: 520 3rd Street CITY/STATE/ZIP: Oakland, CA 94607 <br /> PHONE(1): 510.907.3145 x2109 PHONE(2): 510-681-7818 FAX OR E-MAIL: <br /> eSrlirlar.�,�r�^airr)nvlllf^nt¢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 anpoir�tet�t,date and time to review the requested records. <br /> SIGNATURE OF APPLICANT Elizabeth Scudero' DATE May 15,2018­ <br /> 1. m <br /> 1. List up to ten addresses in the space below. Address�rangesWILL 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 infoOsicehd 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 /> FFHEATH <br /> MENTAL FILE ADDRESS 2 <br /> PARTMENT <br /> ES (Specific addresses only,address ranges will not be accepted) EHD USE ONLY <br /> ank(UST) Street# Street Name City <br /> OP) L_\! lyr�,t-y 1 tEl CONSUMER <br /> eanupSite(Non-LOP) 1 100 Valpico Road Tracy 2 <br /> ©Hazardous Waste <br /> 0 Tiered Permitted Facility DAIRY <br /> 2 75 Vaip1C0 ROaC� Tracy <br /> Aboveground Tank n0 50 CWQq) <br /> ®UST (Monitoring/Removal) PWS <br /> ©Hazardous Materials 3 Release case records only <br /> ®Spill/Release Response Case #694 <br /> Solid Waste Facility/Vehicle a WATER QUALITY <br /> ❑ Food Facility <br /> ❑Pool/Spa $ITE MITIGATION <br /> F]Dairy 5 <br /> Land Use Application Sites All records on-file, <br /> including two H USING <br /> ®Septic Pumper Truck/ 5 <br /> Yard/Chemical Toilets closed LUST <br /> ©Wastewater Treatment Plant cases: #14231 and <br /> CUPA <br /> F-]Housing Abatement 7 #142323 AST/HM/HW <br /> ®Motel/Hotel <br /> ❑Chicken Ranch/Dog Kennel �UpA <br /> r Medical Waste Facility 8 UST <br /> F]Tattoo/Body Piercing <br /> ®Waste Tire 9 $OLID WASTE <br /> F1 Complaint <br /> F]Other(Please Specify): p ACCOUNTING <br /> 10 <br /> ***BOXED AREA-EHD USE ONLY*** <br /> • `J-Ir7" �l"`[r-ti.l�e �.n'E-e•' !`c?Ci3;(1 i;� �.� -(-v^�e�.v'h � N,ct stn I r= .�v <br /> V <br /> cf) CsZ-21- ' fr C.UOD3 <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: #1 CO^)� lA ( ae-os <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />