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OV From: 2096615520 Tue Aug 15 22:49:47 2017 Page 1 of 1 <br /> x �1VFt)2Wd SAN JOAQUIN COUNTY <br /> EHD013 <br /> LOGNUMBER <br /> X 49-110 ENVIRONMENTAL HEALTH DEPARTMENT AUG 15 2017414!(4"1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> �PF�MAua. PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Kelly Gillogly BUSINESS/AGENCY:Sierra Delta Consultants <br /> ADDRESS: 3731 Incline Way CITY/STATE/ZIP: Riverbank, CA 95367 <br /> PHONE(1): 559.300.7747 PHONE(2): FACSIMILE-805.239,9309 <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 /> F-1CHECKBOX TO EXPEDITE REQUEST-$130 FEE(CASH OR CHECK ONLY)- REQUEST PROCESSED IN 3 BUSINESS DAYS lye/2i.I <br /> SIGNATURE OF APPLICANT Kelly Gillogly s;R mm•�- - --- DATE olyls2on V( 1 <br /> Electronic Information: ❑ List ❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY CVtjPl <br /> Street# Street Name City <br /> 1. 11780 N Hwy 99 Lodi, CA 95240 p/� /� L�aA- Nn <br /> 2. 4594 E Live Oak Road Lodi, CA 95240 <br /> 3. (rl telAi l 4`j <br /> 4. (N <br /> 5. -Ti IlOL/ <br /> C�' U 5'it-C Kt-6,1AIVI <br /> 6. gel <br /> 7. S r1 WJ:S�C <br /> 8. Dd <br /> 9. <br /> 10. <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> Q UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY Q SOLID WASTE FACILITYfVEHICLE <br /> Q OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT WASTE TIRE <br /> Q UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> Q ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> Q HAZARDOUS WASTE/HAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOUSPA ❑LAND USE APPLICATION SITES <br /> ❑TATTODIBODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM (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$130 deposit prior to review. 'BOXED AREA- EHD USE ONLY*** <br /> —�ca ,A kA ner.4 J RgA <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> Received Time Aug. 15. 2017 3 :44PM No. 2100 °�°'"' <br />