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RECEIVID <br /> SAK.00AQUIN MAY 20:8, Environmental Health Department <br /> —COUNTY - PUBLIC RECORDS RELEASE APPLICATION <br /> At*: <br /> brtl''d5 here W <br /> I ( R AIL <br /> • <br /> EHD LOG NUMBER..`0 <br /> 10q 30 <br /> APPLICANT: TAMARA WOODS BUSINESS/AGENCY:TERRACON <br /> ADDRESS: 902 INDUSTRIAL WAY CITY/STATE/ZIP:LODI,CA 95240 <br /> PHONE(1): 209-269-8586 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 /> SIGNATURE OF APPLICANTDi9imllysignedbyWoods,TamaraK DATE 5-22-18 <br /> VVoods, Tamara T <br /> 1. List up to ten addresses in the spade below. Aj4gWaX@jpgpqyVILL NOT be accepted. Select the type(s)of files from the <br /> list below by checking the appropriate box(e!P" At'1 alM"I5ff6'file type MUST be selected. Fax to(209)464-0138, mail to the <br /> address indicated below,or email to info(d)sicehd.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 ALL AVAILABLE YEARS to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT ( ponly, 9 p ) EHD USE ON Y <br /> FILES S ecific addresses address ranges will not be accepted) <br /> ❑X Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) ❑CONSUMER <br /> RX Other Cleanup Site(Non L 1 2830 AUTO PLAZA DRIVE TRACY <br /> Q Hazardous Waste ❑DAIRY <br /> Q Tiered Permitted Facility 2 <br /> Q Aboveground Tank <br /> ❑X UST (Monitoring/Removal) ❑PWS <br /> ❑X 3 Hazardous Materials � •1 ZnI„ih�fp <br /> ❑X Spill/Release Response ('��rl,�J I_Jl/ <br /> 11 1M 9 ATER QUALITY <br /> fX Solid Waste Facility/Vehicle 4 t <br /> Food Facility <br /> Pool/Spa $ITE MITIGATION <br /> ❑Dairy 5 1 <br /> ❑K Land Use Application Sites /� `/s /� <br /> �������V I Y\ M tA' h/� E]HOUSING <br /> Septic Pumper Truck I 6 <br /> Yard/Chemical Toilets <br /> ❑Wastewater Treatment Plant CUPA <br /> Housing Abatement T AST I HM I HW <br /> F]Motel/Hotel <br /> UPA <br /> F-1Chicken Ranch/Dog Kennel <br /> 8 UST <br /> Medical Waste Facility <br /> Tattoo/Body Piercing OLID WASTE <br /> Waste Tire g <br /> ❑X Complaint <br /> Other(Please Specify): ❑ACCOUNTING <br /> 10 <br /> ***BOXED AREA-EHD USE ONLY <br /> 911 <br /> ❑ Records provided by Staff-PPR Complete. Starr me: 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 />