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���`� <br /> � �- � E' <br /> '�t [E SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENViRONMENTAL HEALTH DEPARTMENT <br /> MAY 2 6 2016 1868 East Hazelton Avenue, Stockton, CA 95205-6232 ?�goq <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> &MRONMEt�MkL HEALTH <br /> PERMITfSEFNICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Abby Racco _ BUSINESS/AGENCY: Live OakyeOEnyironimenta <br /> ADDRESS: 407 W. Oak St. CITY/STATE/ZIP: Lodi, CA 95240 <br /> PHONE (1): 369-0375 PHONE (2): 365-3222 FACSIMILE: 369-0377 <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 AHy2G�—w DATE 5-26-16 <br /> Electronic Information: ❑ List ❑ Map— Description: <br /> FILE ADDRESS _ <br /> Street# Street Name City EHD USE ONLY T <br /> 1• 23800 N. Jack Tone Rd. A Acampo <br /> 2. 23490 N. Jack Tone Rd.1v I Acampo 40 ❑ Unit 1 <br /> j� 3. 14680 E. Jahant Rd. Acampof ti /5/� unit 2 <br /> 4. 14615 E. Peltier Rd. . Acampo A t b14N0 CD/ i Unit 2H <br /> 5. <br /> 6. Unit 3 <br /> 7• Unit 4 <br /> 8• [9/SITE MITIGATION <br /> 9. <br /> 10. ❑ Unit 5 <br /> Specific Date Range of Information Requested: From all available to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILITYNEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE rrv� � A(,Isjl T, <br /> ®UNDERGROUND TANK(MONITORING/REMOVAL)-,\_ ❑FOOD FACILITY ❑DAIRY &.44b <br /> ®ABOVEGROUND TANK a ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TR ATMENT PLANT <br /> ®HAZARDOUS WASTE/HAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> X1 TIERED PERMITTED FACILITY ❑POOL/SPA LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING COMPLAINTIRESPONSE RECORDS ®OTHER(PLf;AS SPECace�F bsurface Rpt <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the type(s) of files from the list above 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 staffs at the expense of the applicant. <br /> Future file reviews by the same applicant may require a $130 deposit prior to review. ""BOXED AREA-EHD USE ONLY"' <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> EHD 48-06 T1!15 <br />