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DAREEIVED SAN JOAQUIN COUN EHD LOG NUMBER <br /> 4499 ENVIRONMENTAL HEALTH DIOf <br /> � Ir 7 p �a�� 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> PERM ITL,1=RtENTAL r <br /> ENV HEALTH Telephone: <br /> RECORDS RELEASE APPLICATION <br /> n�F� <br /> APPLICANT: Abby Racco BUSINESS/AGENCY: Live Oak Geo Environmental <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 Adv 2a,{ cc 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 FILE ADDRESS <br /> FILES <br /> EHD USE ONLY <br /> UNDERGROUND TANK(UST) Street# Street Name City <br /> CLEANUP SITE(LOP) CONSUMER <br /> ®OTHER CLEANUP SITE(NON-LOP) ' 18626 E. Copperopolis Rd. Linden/St( U t <br /> ®HAZARDOUS WASTE _ DAIRY <br /> TIERED PERMITTED FACILITY ^� 2 18704 E. Copperopolis Rd. inden/Stockto <br /> ®ABOVEGROUND TANK <br /> ®UST (MONITORING/REMOVAL) 3 .18638 E. Copperopolis Rd. inden/Stockto �� ❑PWS <br /> ®HAZARDOUS MATERIALS O J V <br /> ®SPILL/RELEASE RESPONSE <br /> SOLID WASTE FACILITY/ CLE 4 18190 E. Copperopolis Rd. inden/Stockto / WATER QUALITY <br /> FOOD FACILITY ,�,1;.�� <br /> F]POOL/SPA _ ! ���1� SITE MITIGATION <br /> DAIRY 5 17986 E. Copperopolis Rd. inden/Stockto 1T0 t <br /> ❑LAND USE APPLICATION SITES <br /> SEPTIC PUMPER TRUCK/ - -I-�1 - 'V 1:1 HOUSING <br /> F16 18802 E. Copperopolis Rd. inden/Stockto <br /> YARD/CHEMICAL TOILETS <br /> ❑WASTEWATER TREATMENT PLANT CUPA <br /> ❑HOUSING ABATEMENT — 7 17590 E. Copperopolis Rd. inden/Stockto <br /> F-]MOTEL/HOTEL <br /> F�CHICKEN RANCH/DOG KENNEL�- 103 M CUPA- A!-1C17{T <br /> F]MEDICAL WASTE FACILITY 155 N. Duncan inden/StocktoF-1TATTOO/BODY PIERCING n <br /> F]WASTE TIRE 9 791 Drais inden/Stockto i�,1v.v SOLID WASTE <br /> COMPLAINT <br /> F-1 OTHER(PLEASE SPECIFY): ito I -•� ;'Q ACCOUNTING <br /> ao 14 <br /> —BOXED AREA-EHD USE ONLY* tool <br /> -y 1 <br /> ❑ Records provided by Staff-PPR Complete. stats Name: <br /> EHD 48-06 <br />