Laserfiche WebLink
QI!t DFILm COPY <br /> SAN-JOAQUIN EnAronmental Health Department <br /> COU NTY-- Ma PUBLIC RECORDS RELEASE APPLICATION <br /> `IR3N,�. <br /> }�tPTI J amt 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 <br /> DOM MLdASM 14'.Nl40-01DP DATE 5/2r2o18 <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(a2sicehd.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: ,^, i'-- <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> f p y 9 p <br /> FILES (Specific addresses only,address ranges will not be accepted) <br /> E H D M S E ONLY NLY <br /> Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) �� 14��t �y-��r.;?}�µ• ®CONSUMER <br /> Q Other Cleanup Site(NonLOP14900 W. � g hvV�y 1 � T <br /> Q Hazardous Waste t 4ti�# h �r <br /> J/ ®DAIRY <br /> 0 Tiered Permitted Facility 2 14850 W. ' u gg d 9 NV ay 12 Lodi <br /> Q Aboveground Tank YY <br /> Q UST (Monitoring/Removal) ❑PWS <br /> QHazardous Materials ' 14980W. Highway 12 Lodi' <br /> Q Spill/Release Response <br /> ®Solid Waste Facility/Vehicle 4 14820W. Highway 12 Lodi ® ATER QUALITY <br /> Q Food Facility L43 <br /> yy <br /> Q Pool/Spa G i f v SITE MITIGATION <br /> Q Dairy 5 14440 �. Highway 12 Lodi <br /> Q Land Use Application Sites <br /> 0 Septic Pumper Truck/ Q OUSING <br /> s <br /> Yard/Chemical Toilets <br /> Q Wastewater Treatment Plant CUPA <br /> Housing Abatement 7 AST©/HW <br /> Q Motel/Hotel <br /> Q Chicken Ranch 1 Dog Kennel [ CUPA <br /> 0 s Medical Waste Facility UST <br /> Tattoo/Body Piercing <br /> ®waste Tire Saud WAS <br /> s <br /> ®Complaint <br /> Other(Please Specify): ❑ACCOUNTING <br /> 10 <br /> ({ J 4 '*`Be JOXEED AREA-EHD USE ONLY' <br /> ' ��'t(t3 �.`,.:ry.^.ai4,t'_.tA i� ti. {,s='tl;..+t";,'-'u'+L'�l F`C.i.{/:t�•�K t/1^ E A1is /Ek�'1� G�` �„4'.'V , �P'oCr lL�(4. I 'C'4!i�3a� <br /> e <br /> ❑ Records provided by Staff-PPR Complete.staff Name: EHD 48-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />