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- 11 SAN JOAQUIN COUNTY EHD LOG NUMBER <br />SEP 1 1 2015 ENVIRONMENTAL HEALTH DEPARTMENT �6 <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 0 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br />EMfIRON[ViENTAL HEALTH <br />PERMIT/SEPMCES PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: TAMMY WOODS <br />ADDRESS: 902 INDUSTRIAL WAY <br />PHONE (1): 209-367-3701 <br />PHONE (2): <br />BUSINESS/AGENCY: NOA/TERRACON <br />CITY/STATE/ZIP: LODI. CA 95240 <br />FACSIMILE: 209-333-8303 <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 TKWOODS@TERRACON.COM DATE 09-11-15 <br />Electronic Information: ❑ List ❑ Map — Description: <br />e srt A-,,- LO o,vU3-\ oa q k O Lv D. I6 (or <br />FILE ADDRESS <br />EHD USE ONLY <br />❑ MEDICAL WASTE FACILITY <br />Street # <br />Street Name <br />City <br />1. <br />4932 <br />5151 <br />5110 <br />Pacific Avenue <br />Pacific Avenue <br />Pacific Avenue <br />STOCKTON <br />I STOCK T ON <br />I STOCKTONL—it <br />Lew�_(,on� <br />5 Kw C <br />4 (C An <br />2. <br />3. <br />4t <br />4. <br />❑ Unit 2H <br />5. <br />iL^Je& OAL Pik% til tap. <br />(]''Unit 3 <br />6. <br />7. <br />19/Unit Unit 4 <br />8. <br />SI'SITE MITIGATION <br />9. <br />�Unit 5 <br />10. <br />Specific Date Range of Information Requested: From <br />e srt A-,,- LO o,vU3-\ oa q k O Lv D. I6 (or <br />—ALL <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />X UNDERGROUND TANK (UST) CLEANUP SITE (LOP) <br />❑ MEDICAL WASTE FACILITY <br />X OTHER CLEANUP SITE (NON -LOP) <br />❑ HOUSING ABATEMENT <br />13 i UNDERGROUND TANK (MONITORING/REMOVAL) <br />❑ FOOD FACILITY <br />X ABOVEGROUND TANK <br />❑ CHICKEN RANCH/ DOG KENNEL <br />HAZARDOUS WASTEIHAZARDOUS MATERIALS <br />❑ MOTELIHOTEL <br />�J TIERED PERMITTED FACILITY <br />❑ POOUSPA <br />LJ TATTOOIBODY PIERCING <br />COMPLAINTIRESPONSE RECORDS <br />to <br />F SOLID WASTE FACILITYIVEHICLE <br />IX WASTE TIRE <br />❑ DAIRY <br />WASTEWATER TREATMENT PLANT <br />❑ PUMPER TRUCKIYARDICHEMICAL TOILETS <br />LAND USE APPLICATION SITES <br />❑ 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 $130 deposit prior to review. ***BOXED AREA - EHD USE ONLY*** <br />*1Ae$ ?; Io& <br />e srt A-,,- LO o,vU3-\ oa q k O Lv D. I6 (or <br />51 �l h i ie <br />ik ve- (J90,)o0 -!; qui W519I1c,1Fic Ave:k-ok <br />s P ye. " fo t.4r �I`I c,�1 t0 a'�ke. Ave V c . <br />//��cc <br />_PL9,jeJ M I <br />I[t.'c. /j-6 <br />17(110pa() <br />, 0 pi, 7 (11 0 a() V, lam'.. V� to . <br />❑ Records provided by Staff -PPR Complete. Staff Name: <br />EHD 48.06 <br />711/15 <br />