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r � <br /> t � <br /> t¢ REWED <br /> IRB 0 SAN JQAQUfN COUNTY EHD LOG NUMBER• <br /> IMV NOV 0 2 2015 ENVIRONmrzNTAL HE=ALTH DEPARTMENT �•� <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (2'09) 468-3420 Fax: (209) 464-0138 Vyeb: www_sigov.org/ehd <br /> ( cNVIRONMENTALHEALTH <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Abby l3acco BUSINESSrAGENCY: Live Oak GeoEnvironmental <br /> ADDRESS: -407 W. Oak St CETY✓STATEIZIP: Lodi, CA 95240 <br /> PHONE.(1j: 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- f=EE(CA OR CHECK ONLY)-REQUEST PROCEs$ED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT 15 <br /> I ( `t <br /> Electronic Information: ❑List❑Map—Description: <br /> FILE ADDRESS <br /> Street M Streat.Namecty EHD USE ONLY <br /> 1: ySl Cf0 ,S'• !!cr,SSa-h Tnt 1'-CO <br /> 2• ZSv° ' S. KcLSSa1-� o- w�� <br /> a. I-(o"r`r-t:A LLev:.-Co unit .5�3 h 5• �srm <br /> Unit <br /> 4. a3s--� s. Kat:sdt., •• C 5-t kfMp�soHS-c-fQ(�pn-ce I Il� <br /> 5. GCctPov�fes- Cka v(t v E'ro $irn C-w�x3-� t0 <br /> s: �(�oolfos4� {Uri- 1'flT+' �i�i�s u itg <br /> 7. �tJ� <br /> ✓ Unit4 <br /> 8 t I•(�is 91TE MITIGATION <br /> 9. <br /> 10. <br /> ❑Unit 5 <br /> Specific Date Range of informalion Requested: From all availflble <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILITYNEHICLE <br /> ZI OTHER CLEA NUP SITE(NON-LOP) ❑HOUSING ABATEMENT Ll WASTE TIRE <br /> ®UNDERGROUND TANK(MONITORING/REMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ®ABOVEGROUND TANK El CHICKEN RANCH/DOG KENNEL q WASTEWATER TREATMENT PLANT <br /> ®HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTEL/HOTEL ❑PUMPER TRUCK/YARDICHEMICAL TOILETS <br /> ®TIERED PERMITTED FACILITY ❑POOUSPA <br /> ❑TATTOO/BODY PIERCING I� El LAND USE APPLICATION SITES <br /> 141 COMPLAINTJRESPONSE RECORDS Ll OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVA LABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) ' <br /> 1 List Up to ten addresses,in the space above, Select the type(s)of fifes from the list above by checking the appropriate <br /> I)ox(e3). At least one file type MUST be selected. Fax to 1209)464-0138 or mall to the address indicated above Address <br /> ranges will not be accepted.Applications received after 9:00 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 /> ' S. 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 applfcant may requlre a$130 deposit prior to review. —BOXED AREA-EHD USE ONLY"' <br /> rov aA [4 W, Fur lar �� .z �o) . �;w v O" 21 vt.t Q. pivalet NYC Gl 4P ea <br /> f rrJd Ub EUe1 <br /> r k . b C�. U k e 4 Cl,e } boa <br /> K <br /> 25,012 k4, on 14.�p x- gel.Co an Cp G16 60,,2h 70 [ov01� 0 13 Vf" cvtl(00001 3q. 61 <br /> 23 rw ttJl v <br /> 01. "Ikk f*iwtl,t„t �w.37rt r isfUO 5Al A vlkG <br /> ❑ Records provided by Staff-PPR Complete. staff.Name: <br /> EHD 49-06 <br /> Tnns <br /> Received Time Nov, 2, 2015 9:27AM No, 9931 . <br />