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RECEIVED <br />- SAN J Q A Q U I N Environmental Health Department <br />" " COUNTY �'Y�` PU�LIC RECORDS RELEASE APPLICATION <br />Greotness grows he,reaMi ONMWAL <br />wwH ,\17� "� 011"7 Ci <br />P'�i1MrTl�1 m S EHD LOG NUMBER: <br />• <br />is <br />• <br />APPLICANT: Abby Racco <br />BUSINESS/AGENcY: Live Oak GeoEnvironmental <br />ADDRESS: 407 W. Oak St. CITY/STATE/ZIP: Lodi, CA 95240 <br />PHONE (1): 369-0375 PHONE (2): 365-3222 FAX OR E-MAIL: abby@logelodi.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 oVd4 Raaca DATE May 16, 2018 <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(a)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. 2 <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: <br />Specific Date Range of Information Requested: From to <br />ENVIRONMENTAL <br />FILE ADDRESS <br />1� lQ (g <br />HEALTH DEPARTMENT <br />FILES <br />(Specific addresses <br />(p <br />only, address ranges will not <br />y 9 <br />be acce ted <br />accepted) <br />EHD USE ONLY <br />® Underground Tank (UST) <br />Street # <br />Street Name <br />City <br />Cleanup Site (LOP)f-' <br />1 <br />21025 <br />S. Jack Tone N • <br />on <br />® Other Cleanup Site (Non -LOP) <br />® Hazardous Waste <br />❑ DAIRY <br />® Tiered Permitted Facility <br />2 <br />21003 <br />S. Jack Tone <br />Ripon <br />® Aboveground Tank <br />it"l Cd <br />20449 <br />S. Jack Tone <br />Fon <br />❑ PWS <br />UST (Monitoring / Removal) <br />Hazardous Materials <br />. <br />• <br />13 t1� % S <br />iA Spill / Release Response <br />4 <br />21123 <br />S. Jack Tone <br />WATER QUALITY <br />[Z Solid Waste Facility / Vehicle <br />F1 Food Facility <br />_Ryon <br />l t M <br />thm <br />5 <br />20992 <br />S. Olive <br />Ripon <br />SITE MITIGATION <br />Pool I Spa <br />F] Dairy <br />IiM <br />n `�Y V no Co S <br />❑ Land Use Application Sites�1, <br />HOUSING <br />Septic Pumper Truck I <br />8 <br />Yard / Chemical Toilets <br />CUPA <br />❑ Wastewater Treatment Plant <br />Housing Abatement <br />7 <br />AST / HM / HW <br />E] Motel/Hotel <br />CUPA <br />,,n <br />F] Chicken Ranch / Dog Kennel <br />Medical Waste Facility <br />8 <br />UST <br />Tattoo/Body Piercing <br />SOLID WASTE <br />Waste Tire <br />g <br />Complaint <br />❑ ACCOUNTING <br />❑ Other (Please Specify): <br />10 <br />—BOXED AREA - EHD USE ONLY- <br />-Kl I _r ,its Q [;�.�4 iil •k rzic�n� 0 <br />b At 211'13 S. Tai m, ` PROsA 3. <br />❑ Records provided by Staff-PPI4 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 />