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08/06/2015 12:57 92574660 AEICONSULTANTS PAGE 01/01 <br /> �RECEIVED EHD G Ut✓ <br /> � ��C�! SAN•.JOAQUIN COUNTY _ r6gf <br /> fG ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone; (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> ('- �ry � �. i'� PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:__l IIh )IOCJK BUSINESS[AGENCY: AEI CdVI( ( )d <br /> ADDRESS: �� d �b (� CITY[STATEIZIP:_VUAI0(/Il-l.rPel-, <br /> PHONE ( �p25 ] 0- (DUI PHONE(2) 74{ - () (',O FACSIMILE: qZS -((!O aq <br /> Tease 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 RE UE T-$130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANTY ( IZ'ri L )61C DATE rO(pl�S <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS <br /> Street 0 Street NameCity ENO USE ONLY <br /> t. ?-1- &SLI Wq Tree E5(a(o tir <br /> 2. 24 9sq Lol,e Tree Rood, - ESCaltlri rvFF <br /> o Unit, <br /> s. 25325 L.on2.Tree p_oaol ESCalvll N�t� yh <br /> a. 2S�i i i Unit Lo)^e T( ee ca(oyl i ZH <br /> 5. IS065 Esco,lci� Y3eljcrfa <br /> I7-�G� L—`SCR.(oa-i ak <br /> s. <br /> Unit 3 <br /> 7iIJrke 9gtl , ( -"unite <br /> 9. <br /> N<T ,�SITE MITIGATION <br /> i <br /> 10. -(a <br /> ❑Unit 5 <br /> Specific Date Range oP Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> /UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILI YNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) 0 HOUSING ABATEMENT ❑WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ABOVEGROUND TANK ❑CHICKEN RANCH[DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> HAZARDOUS WASTEIHAZARDO US MATERIALS ❑MOTELIHOTLL ❑PUMPER TRUCKJYARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILDY ❑POOLISPA ❑LAND USE APPLICATION SRES <br /> ❑TATTOolBODY PIERCING �PLAINT1REsPoNSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 5;00 AM-5:OOPNI (EXCLUDING HOLIDAYS) <br /> 1. Li=t io to ten-ddresses In the space above. Select the type(s)of files from the list above b checking the a <br /> Y g ppropriate <br /> ran(es). At least one file type MUST io selected. Fax to(209)464-0138 or mail to the address Ind c ted gbove 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 /> 12 <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 fora 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$130 deposit prior to review. "'"60XED ARA HD US O Y^°" <br /> Y(C.� i11i1 /STA 1 I <br /> I 1 ll) <br /> I-vi �, L1(-\. 1/ /�n <br /> 1-1v Vilp-i„a I n . C4r�l,, �clta>dr . !ria ; t0at�v1 <br /> ` � Records provided by"Statt-Pre< ,.ompl ore4T-meel a I "L.G ,� t'i�lo l(9 t r1�4u1 G� M <br /> C Pat r l ti'(L Qt PSt>..la-t te'kw <br /> Received Time Aug. 6. 2015 12: 56PM No. 2281 tnNs <br />