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r Q�/��t-�M Yll'1' '1'U: 1'LU�4Id4013U Ptlum : yl(i3'180'/'L4 page : Z <br /> f �,�4' SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> AUG 2 2 2011 4-te- 3R"- ENVIRONMENTAL HEALTH DEPARTMENT <br /> UppppgqTED REQUEST 1: (2 East Hazel8-342 Fax:Avenue,09 Stockton, CA b:www,sjgov.org/ehd <br /> ENVIROffINENTALHEALTIH Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> PERMITfSERUICES PUBLIC RECORDS RELEASE APPLICATION <br /> PPLICANT: Heather Crotty BUSINESS/AGENCY: eScreenLogic <br /> ADDRESS: 1124'9 Gold Country Blvd. CITY/STATE/ZIP: Gold River, CA 95670 <br /> PHONE(1): 916-288-8174 PHONE(2): FAX OR E-MAIL: h.crotty@escreenlogic.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 EXPEDITER QUEST-$1n39 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT yjIgat Pit, I DATE 8/22/17 <br /> 1. List up to ten addresses in the space below. Sele 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. (��2I <br /> Future file reviews by the same applicant may require a$139 deposit prior to review. �'l J <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 to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESSFILES c� EHD USE ONLY <br /> UNDERGROUND TANK(LIST) Street# Street Name City <br /> CLEANUP SITE(LOP) L]CONSUMER <br /> OTHER CLEANUP SITE(NON-LOP) 1220 E Pine St--UST v <br /> Lodi <br /> HAZARDOUS WASTE C]DURY <br /> ❑TIERED PERMITTED FACILITY 2 <br /> ❑ABOVEGROUND TANK 1204 EPine St. Lodi <br /> F1 UST (MONITORING/REMOVAL) EI PWS <br /> HAZARDOUS MATERIALS 3 <br /> ❑SPILURELEASE RESPONSE 1206 E Pine St. Lodi w 1`t <br /> ❑SOLID WASTE FACILITY I VEHICLE WnTER QUALrtY <br /> ❑FOOD FACILITY 1240 E Pine SL-UST Lodi 1vl Y Y <br /> ❑POOL/SPAi1, 1) ,1 •,/JLC s/y�� —rC (/��/�/t SITE MITIGATION <br /> ❑DAIRY <br /> ❑LAND USE APPLICATION SITES 12 S Cuff Ave.-HM&HW Lodi pNtn-� <br /> ❑SEPTIC PUMPER TRUCK/ e E Pine St.-looking for Historic �i wvu '„�rpr/pv`� HOUSING <br /> YARDICHEMICALTOILPfS 1126 UST removal date Lodi V' N <br /> ❑WASTEWATER TREATMENT PLANT <br /> N Cluff Ave.-Leaking mg uPA <br /> ❑HOUSING ABATEMENT T Underground I I <br /> ❑MoTELIHOTEL 42 Storage Tank Documents Lodi <br /> CHICKEN RANCH I DOG KENNEL &tUPA-UST <br /> ❑MEDICAL WASTE FACILITY 3 <br /> ❑TATTOO/BODY PIERCING <br /> ❑WASTE TIRE ❑SOLID WAS iE <br /> 9 <br /> ❑COMPWNT <br /> ❑OTHER(PLEASE SPECIFY): Q ACCOUNTING <br /> 10 <br /> 22 ED AREA E D USE <br /> S O L <br /> ❑ Records provided by Staff-PPR Complete, staff Name: 7 G <br /> Received Time=Aug, 22, -2017- 3 : 54PNFNo. 214Q <br />