Laserfiche WebLink
RECEIVED <br /> SAN J 0 A Q U I N MAY 01 201, Environmental Health Department <br /> —COUNTY— ( Fey 7( n PUBLIC RECORDS RELEASE APPLICATION <br /> • <br /> Greatness grows her <br /> dEWRQ <br /> PEF <br /> AMff IL �! <br /> EHD LOG NUMBER: <br /> APPLICANT: Eric Ehlers BUSINESS/AGENCY:AKT Peerless <br /> ADDRESS: 1761 Arlington Blvd CITY/STATE/ZIP:EI Cerrito,CA 94530 <br /> PHONE(1): 510.529-9555 PHONE(2): FAX OR E-MAIL: ehlerse@aktpeerless.com <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 Eric Ehlers DATE 5l21201e <br /> 1. List uD 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(&sicehd.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. 1/11 <br /> Future file reviews by the same applicant may require a$152 deposit prior to review. .J <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map—Description: All files <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT only, 9 accepted) EHD USE ONLY <br /> FILES (Specific addresses address ranges will not he acce ted <br /> Q Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) ` "At WNI" onscmEa <br /> • 11W 5L I Q 14900 W. Highway 12Other Cleanup Site(Non-LOP) <br /> i <br /> MX Hazardous Waste 6�jC-� DAl- <br /> Q Tiered Permitted Facility 2 14850W. Highway 12 Lodi <br /> MX Aboveground Tank <br /> 0 UST (Monitoring/Removal) PWS <br /> N Hazardous Materials a 14980W. Highway 12 Lodi <br /> 0 Spill/Release Response <br /> ATER QUALITY <br /> Q Solid Waste Facility/Vehicle 4 14820W. Highway 12 Lodi <br /> Q Food Facility <br /> Q Pool/Spa SITE MITIGATON <br /> QDairy 5 14440W. Highway 12 Lodi <br /> Q Land Use Application Sites <br /> ouslrvc <br /> nx Septic Pumper Truck/ a <br /> Yard/Chemical Toilets <br /> Q Wastewater Treatment Plant (CUPA <br /> ❑Housing Abatement 7 AST I HM I HW <br /> 0 Motel/Hotel ~ <br /> Q Chicken Ranch/Dog Kennel CUPA <br /> a UST <br /> Q Medical Waste Facility <br /> F1 Tattoo/Body Piercing SouDWASTE <br /> MX Waste Tire a <br /> O Complaint <br /> ❑Other(Please Specify): C ❑ACCOUNTING <br /> 10 <br /> "*BOXED AREA-EHD USE ONLY*** <br /> ❑ Records provided by Staff-PPR Complete. staff Name: EHD4e-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 />