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KE:GE 1lr LEn_f'-- D, <br />DATE CErLF <br />IVED _ ., SAN JOAQUIN COUNTRU�H EHD LOG NUMBER <br />.i N 19 201? vM <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />2WRONMEN'TAL FMALTH 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />PE1WlT/SERlil_Z2 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: TAMMY WOODS <br />ADDRESS: 902 INDUSTRIAL WAY <br />BUSINESS/AGENCY: TERRACON <br />CITY/STATE/ZIP: LODI, CA 95240 <br />PHONE (1): 209-367-3701 PHONE (2): FAX OR E-MAIL: tkwoods(&terracon.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 Iia '.� ; a / �&S � DATE 01-03-2017 <br />I. 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 />Electronic Information: ❑ List ❑ Map — Description: <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />FILES <br />FILE ADDRESS <br />10 (11 1, 1, �- ic,� I _ ZO-1 <br />EHD USE ONLY <br />® UNDERGROUND TANK (UST) <br />Street # <br />Street Name <br />City <br />CLEANUP SITE (LOP) <br />® OTHER CLEANUP SITE (NON -LOP) <br />24511 <br />N. ST RT 99 <br />ACAMPO <br />/ �' ❑ CONSUMER <br />® HAZARDOUS WASTE <br />® TIERED PERMITTED FACILITY <br />2 <br />24327 <br />N. ST RT 99 <br />ACAMPO <br />oq <br />I N D 60 ❑ DAIRY <br />® ABOVEGROUND TANK <br />i �� / G ❑ PWS <br />® UST (MONITORING I REMOVAL <br />® HAZARDOUS MATERIALS <br />®SPILLIRELEASE RESPONSE <br />® SOLID WASTE FACILITY / VEHICLE <br />FOOD FACILITY <br />s <br />24323 <br />N. 5T RT 99 <br />ACAMPO <br />cwEM-F-A0ooH3L15 <br />4 <br />24355 <br />N. ST RT 99 <br />ACAM PO <br />/51 WATER QUALITY <br />e <br />24155 <br />N. ST RT 99 <br />ACAMPO <br />CW <br />SITE MITIGATION <br />C",4C01�� <br />POOL/ SPA <br />DAIRY <br />❑ LAND USE APPLICATION SITES <br />❑ SEPTIC PUMPER TRUCK I <br />YARD I CHEMICAL TOILETS <br />❑ WASTEWATER TREATMENT PLANT <br />HOUSING ABATEMENT <br />6 <br />23987 <br />N. ST RT 99 <br />ACAMPO <br />❑ HOUSING <br />N �h <br />i , <br />q 9 CIOO A (� �� <br />7 <br />C:t16 M_ - L U CUPA <br />FA 0nVO7 ✓ <br />❑ MOTEL/HOTEL <br />FA Coit 110 ✓ US <br />a <br />CUPA-HAi-MAT <br />F] CHICKEN RANCH / DOG KENNEL <br />MEDICAL WASTE FACILITY <br />❑ TATTOO/BODY PIERCING <br />[2 SOLID WASTE <br />® WASTE TIRE <br />® COMPLAINT <br />9 <br />® OTHER(PLEASE SPECIFY: <br />❑ ACCOUNTING <br />WELL AND SEPTIC PERMITS <br />For#1,2 & 3 ADDRESS ONLY <br />io <br />Zq <br />t � <br />77 1 r0j( <br />4:4-1,O—A <br />_ II <br />Specific Date Range of Information Requested: From <br />to <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:00PM EXCLUDING HOLIDAYS <br />—BOXED AREA- EHD USE ONLY"' I / j <br />v �d l o `c ala G <br />11 Records provided by Staff -PPR Complete. Staff Name: <br />7 <br />