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E, <br />jQ :) QQQQ "°rye. 1 213ab,Environmental Health Department <br />-- C 0 U N T Y-- PLIBLk RECORDS RELEASE APPLICATION <br />�NVIRONWEi� �At "I t ' W <br />• EMAIL .� Z <br />:5 <br />PERfa'tl?-S R� BY � <br />EHD LOG NUMBER:10 <br />APPLICANT: TAMARAWOODS BUSINESS/AGENCY: TERRACON CONSULTANTS INC <br />ADDRESS: 002 INDUSTRIAL WAY CITY/STATE/ZIP:LODI CA 95240 <br />• <br />• <br />PHONE (1): 209-269 F586 PHONE (2): FAX OR E-MAIL: TAMARA WOODSCTERRACON.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 Woods, Tamara K DATE 7-217-1,3, <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@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 $152 deposit prior to review. <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) <br />Electronic Information: ❑ List ❑ Map — Description: <br />Specific Date Range of Information Requested: From to <br />ENVIRONMENTAL <br />FILE ADDRESS <br />C$ 2 <br />HEALTH DEPARTMENT <br />FILES <br />(Specific addresses <br />only, ranges will not <br />y 9 <br />be accepted) <br />p <br />EHD USE ONLY <br />Q Underground Tank (UST) <br />Street # <br />Street Name <br />City <br />1 <br />BOEING WAY <br />Stockton <br />-, <br />®�'� El CONSUMER <br />Cleanup Site (LOP)1409 <br />❑X Other Cleanup Site (Non -LOP) <br />• NO cu a U <br />❑X Hazardous Waste <br />I'{f.1AIRY <br />❑ <br />F]Tiered Permitted Facility <br />z <br />4114 <br />S. AIRPORT WAY <br />STOCKTON <br />1�—`{,��r,�' <br />Aboveground Tank <br />' �1 C, 1 <br />Ms1.kW <br />❑ PW <br />Q UST (Monitoring / Removal) <br />0 Hazardous Materials <br />3 <br />4101 <br />S. AIRPORT WAY <br />STOCKTON <br />FX Spill / Release Response <br />V <br />l`17- <br />n 1v t) 2, O f[DWATER QUALITY <br />�SolidWasteFacility/Vehicle <br />4 <br />4333 <br />S. AIRPORT WAY <br />STOCKTO <br />�/Ti <br />F] Food Facility <br />���� <br />f vD Cv A-) fD SP <br />9r ,�T i <br />�fi/�/1� NlSITE MITIGATION <br />❑ Pool / Spa <br />E] Dairy ` <br />5 <br />14447 <br />S. AIRPORT WAY <br />STOCKTON <br />HUV A <br />❑ Land Use Application Sites��111 <br />`' ` <br />6 <br />❑ HOUSING <br />C/\`1C <br />Septic Pumper Truck / XU ` <br />Yard / Chemical Toilets <br />Wastewater Treatment Plant <br />[ 6U PA <br />F� Housing Abatement <br />7 <br />AST I HM I HW <br />E] Motel/Hotel <br />E COPA <br />❑ Chicken Ranch / Dog Kennel <br />Medical Waste Facility <br />8 <br />UST <br />Tattoo/Body Piercing <br />❑ SOLID WASTE <br />Waste Tire <br />9 <br />Q Complaint <br />❑ ACCOUNTING <br />E] Other (Please Specify): <br />to <br />—BOXED AREA - EHD USE ONLY— <br />2 vV I:�li� <br />Ij In 11 vV F7112 P13, 1 <br />❑ Records provided by Staff -PPR Complete. Starr Name: ZjjY Prbividglid' 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 />W <br />