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JANUY2 � EHD LOG NUMBER <br /> SAN .10AQUIN COUNTY <br /> _ ENVIRONMENTAL- HEALTH DEPARTMENT -- - . � - j <br /> .JAN 22 7 t� 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> LphoneL(209)-A68n3A2-0-Fax• 2-0�A6 -01 �w <br /> 38-Web; ej. -o_v_oc /_ehd .- <br /> i; . ' R-O w SCE PUBLIC RECORDS RELEASE APPLICATION <br /> PI=FF.f�IT/SEF.�OICES u, <br /> APPLICANT: Ryan Sommers BUSINESS/AGENCY:AEI Consultants <br /> ADDRESS: 3880 South Bascom Avenue CITY/STATE/ZIP: San Jose, CA <br /> PHONE (1): (408) 559-7600 PHONE (2): (408) 528-5744 FACSIMILE: (408) 559-7601 <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 /> ❑ CHECK BOX TO EXPEDITE REQUEST-$130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT Ryan Sommers DATE January 27, 2016 <br /> Electronic Information: ❑ List❑ Map—Description: <br /> _ FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑ Unit 1 <br /> 1. 672 West 11th Streets Tracy, CA <br /> 2. 1129 West 11th Street ,: W\ Tracy, CA U,6nt 2 <br /> 3. ( <br /> 4. 2 r <br /> Unit 3 <br /> `E 1 <br /> 5. <br /> `6' ©knit 4 <br /> $' f2 Unit 5 <br /> 9. y, <br /> 10. <br /> B UniL& <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ®SOLID WASTE FACILITYIVEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ®WASTE TIRE <br /> ®UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ®ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ®WASTEWATER TREATMENT PLANT <br /> ®HAZARDOUS WASTE/HAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ®TIERED PERMITTED FACILITY ❑POOUSPA ®LAND USE APPLICATION SITES <br /> ❑TATTOO/BODY PIERCING ®COMPLAINT/RESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address indicated above. 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 /> 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$125 deposit prior to review. ***BOXED AREA-EHD USE ONLY*** <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> EHD 48.06 <br /> 4128114 <br />