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RECEIVED <br /> SAN JOAQUINFEBf=E� 2 0 2030 Environmental Health Department <br /> —COUNTY-- <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> • � ' r Greatness grows herAWRQNIIA oi3075 <br /> IERIS EMAIL 2.Zt EHD LOG NUMBER: <br /> APPLICANT: Mane Rose Javier BUSINESS/AGENCY:Haley B Aldrich,Inc. <br /> ADDRESS: 2033 North Main Street,Suite 309 CITY/STATE/ZIP:Walnut Creek,CA 94596 <br /> PHONE(1): 925.949.1013 PHONE(2): FAX OR E-MAIL: mlavier@haleyaiddch.mm <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 Marie Rose Javier -- = ----- ----= DATE 2/2on8 <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 info(cDsicehd.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 to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENTFILE ADDRESS ,t-y1,1a <br /> 46 <br /> FILES (Specific addresses only,address ranges will not be accepted) EHlUSE ONLY <br /> Q Underground Tank(UST) Street# Street Name city <br /> Cleanup Site(LOP) (� , ,L71 ❑Caysuuen <br /> X Other Cleanup Site(Non-LOP) <br /> 30600 Corral Hollow Road Tracy mo <br /> D <br /> . Q Hazardous Waste �As7T,4Jpt Cory SrbAIRY <br /> R Tiered Permitted Facility 2 1 <br /> Q Aboveground Tank <br /> RX UST (Monitoring/Removal) ❑PWS <br /> Q Hazardous Materials 3 <br /> Q Spill/Release Response <br /> WATER OIIALI Y <br /> Q Solid Waste Facility/Vehicle 4 <br /> ❑Food Facility <br /> ❑Pool/Spa SnE Maicnnory <br /> RX Dairy 5 <br /> ❑Land Use Application Sites <br /> Houslrve <br /> R Septic Pumper Truck/ 9 ❑ <br /> Yard/Chemical Toilets <br /> Q Wastewater Treatment Plant CUPA <br /> ❑Housing Abatement ] ASTIHM/HW <br /> ❑Motel/Hotel <br /> R Chicken Ranch/Dog Kennel CUPA <br /> Q Medical Waste Facility 8 UST <br /> ❑TattoolBody Piercing SouO Wnsre <br /> Q Waste Tire 9 <br /> ❑X Complaint <br /> ❑Other(Please Specify): ❑Accounnw� <br /> 10 <br /> ***BOXED AREA-EHD USE ONLY*** <br /> 2 d0 14h 'r.:l A Gn `^met re r off' R :nl,9r, iJ e eta cv $ ( rtl vrov Ir ✓ <br /> ZJ` d ad 1&11 <br /> ❑ Records provided by Staff-PPR Complete. staff Name: exoae-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 />