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IED( LCEV V EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH_ �� DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> lq <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> Q �CEf3TALHFT PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 4bby7Racco 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 A19V Rac co DATE 7-27-16 <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 EHD USE ONLY <br /> UNDERGROUND TANK(UST) Street# Street Name city <br /> • CLEANUP SITE(LOP) ❑CONSUMER <br /> ®OTHER CLEANUP SITE(NON-LOP) 1 21399 S. Carrolton Rd. Ripon -�- C <br /> ®HAZARDOUS WASTE El DAIRY <br /> TIERED PERMITTED FACILITY <br /> ®ABOVEGROUND TANK <br /> ®UST (MONITORING/REMOVAL) PWS <br /> ®HAZARDOUS MATERIALS 3 <br /> ®SPILL/RELEASE RESPONSE 0 WATER QUALITY <br /> ❑SOLID WASTE FACILITY/VEHICLE 4 <br /> ❑FOOD FACILITY <br /> POOL/SPA [3Z6rtE MITIGATION <br /> DAIRY S UII <br /> ❑LAND USE APPLICATION SITES <br /> ❑HOUSING <br /> ❑SEPTIC PUMPERTR ICK/ 6 <br /> YARD/CHEMICAL TOILETS <br /> ❑WASTEWATER TREATMENT PLANT CUPA <br /> HOUSING ABATEMENT T <br /> MOTEUHOTEL I ll <br /> CHICKEN RANCH/DOG KENNEL L-J,.J CUPA-p'Cj j <br /> 8 <br /> ❑MEDICAL WASTE FACILITY <br /> ❑TATTOO/BODY PIERCING SMID WASTE <br /> WASTE TIRE p <br /> CONI <br /> ❑OTHER(PLEASE SPECIFY): ❑ACCOUNTING <br /> YD <br /> ***BOXED AREA-EHD USE ONLY*** <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: G <br /> EHD 4"6 <br />