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DA d CEI $ ED SAN JOAQUIN COON �$H <br />EHD LOG NUMBER <br />��99 7 ENVIRONMENTAL HEALTH DoR11 4 <br />AN P �01 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd 5501 <br />ENVIRONMENTAL ISFPj HEALTH PUBLIC RECORDS RELEASE APPLICATION <br />PERMIT/;FlZtnr€� <br />APPLICANT: Abby Racco 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 />CHECK BOX TO EXPEDITE REQUEST - $130 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT Abby Xa,( c DATE 1-18-17 <br />1. List up to ten addresses in the space below. Select the type(s) of files from the list below 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. <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:00PM (EXCLUDING HOLIDAYS) <br />Electronic Information: ❑ List ❑ Map - Description: <br />Specific Date Range of Information Requested: From all available to <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />FILE ADDRESS <br />EHD USE ONLY <br />FILES <br />, <br />UNDERGROUND TANK (UST) <br />Street # <br />Street Name <br />City <br />' <br />18626 <br />E. Copperopolis RdLinden/Stocktoll <br />CLEANUP SITE (LOP) <br />® OTHER CLEANUP SITE (NON -LOP) <br />CONSUMER <br />u <br />r <br />® HAZARDOUS WASTE <br />® TIERED PERMITTED FACILITY <br />2 <br />18704 <br />E. Copperopolis Rd. <br />inden/Stocktoll <br />��, ❑ DAIRY <br />® ABOVEGROUND TANK <br />� ❑ PWS <br />® UST (MONITORING /REMOVAL) <br />® -� <br />HAZARDOUS MATERIALS <br />3 <br />18638 <br />E. Copperopolis Rd. <br />inden/Stockto <br />�� <br />® SPILL/RELEASE RESPONSE <br />4 <br />18190 <br />E. Co peropolis Rd. <br />inden/Stockto <br />14 WATER QUALITY <br />It CV7__ <br />�.-� <br />SOLID WASTE FACILITY/ ICLE <br />FOOD FACILITY <br />S <br />_ <br />� A 1� SITE MITIGATION <br />F ­i POOL/SPA _ <br />❑ DAIRY <br />5 <br />17986 <br />E. Copperopolis Rd. <br />inden/Stockto <br />q+0 <br />LAND USEAPPLICATION SITES <br />B <br />18802 <br />E. Copperopolis Rd. <br />inden/Stockto <br />❑HOUSING <br />F-1SEPTIC PUMPER TRUCK/ <br />YARD / CHEMICAL TOILETS <br />❑ WASTEWATER TREATMENT PLANT <br />CUPA <br />❑ HOUSING ABATEMENT -- <br />7 <br />17590 <br />E. Copperopolis Rd. <br />inden/Stockto <br />❑ MOTEL/HOTEL <br />B <br />155 <br />N. Duncan <br />inden/Stockto <br />E CUPA - NYiL'10iFIT <br />- <br />CHICKEN RANCH / DOG KENNEL <br />MEDICAL WASTE FACILITY <br />_ <br />( v i Q,.�� t , <br />TATTOO/BODY PIERCING <br />(,v� SOLID WASTE <br />WASTE TIRE <br />9 <br />791 <br />Drais <br />inden/Stockto <br />® COMPLAINT <br />1 <br />- <br />VI: . QIACCOUNTING <br />❑ OTHER(PLEASE SPECIFY): <br />DUACU AMt:A - tYIU UJt UNLT-^- <br />❑ Records provided by Staff -PPR Complete. Staff Name: <br />113 <br />