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- SAW] DAnU RECEIVEDEnvironmental Health Department <br /> 4 <br /> COUNT U N T PUBLIC RECORDS RELEASE APPLICATION <br /> --- Y �� ZOOS 1 2.2.�P <br /> ENVIRONMENTAL HEALTH <br /> EHD LOG NUMBER: 816(>'f8 <br /> R1=RlEarr13F R 10C � <br /> APPLICANT: Natalie Vaughan 13USINESSlAGENCY: AE1 Consultants <br /> ADDRESS: 3880 S Bascom Ave, Suite 109 CITYISTATEIZ[P: San ,lose, CA 95124 <br /> PHONE(1): 408-559-7600 PHONE (2): FAX OR E-MAIL: nvallghan4aPir-nngulwnts rnm <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arran�a an appo ntment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT , ��G1� VG�(lq�ayj DATE February 23,2018 <br /> 1. List up to ten addresses in the space below. Addr ss ranges WILL NOT be accepted. Select the type(s) of files from the <br /> fist 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@slcehd.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) �7 <br /> Electronic Information: ❑ List❑ Map--Description: <br /> Specific Date Range of Information Requested: From all to <br /> ENVIRONMENTAL FILE ADDRESS 4- L<�N d 61 <br /> HEALTH DEPARTMENT ( p y 9 accepted) EHD USE ONLY <br /> FILES (Specific addresses only,address ranges will not be ecce ted <br /> ® Underground Tank(UST) Street# Street Name City [�} <br /> Cleanup Site(LOP) CD--'), ❑CCNsuMER ` <br /> Other Cleanup Site(Non-LOP) ' 1789 W Charter Way Stockton` Z ►1�■"7pi"rt1�` <br /> Hazardous Waste (LUST case #9053) �' `7 Fk�rw DAIRY <br /> J lE ' J <br /> Q Tiered Permitted Facility 2 � (��f,,.,�/ <br /> Aboveground Tank YY <br /> ® UST (Monitoring!Removal) [i PWS <br /> © Hazardous Materials s <br /> ®Spill!Release Response <br /> Solid Waste Facility!Vehicle 4 ATER QUALITY <br /> ❑Food Facility <br /> ❑ Pool 1 Spa rE M fIGATION <br /> ❑ Dairy 5 <br /> Land Use Application Sites <br /> OUShNG <br /> ®Septic Pumper Truck 1 6 <br /> Yard I Chemical Toilets <br /> ®Wastewater Treatment Plant COPA <br /> Housing Abatement 7 ASTIHMlHW <br /> ® MotellHctei <br /> Chicken Ranch I Dog Kennel LIPA <br /> �] Medical Waste Facility $ UST <br /> ❑Tattoo/Body Piercing <br /> SOLID WASTE <br /> ®Waste Tire y <br /> ® Complaint <br /> Other(Please Specify): ❑ACCOl1NrING <br /> 10 <br /> 'BOXED AREA-EHD USE O`NLY*1** n <br /> Z- 1`�a" �7 .i�eE �u• 4'• fV_CC <br /> A-z tqof r} polo $` ; <br /> -L EHD 48-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />