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SAN JOAQUIN OCT 0 2U1? Environmental Health Department <br /> - COUNTY - EALM PUBLIC RECORDS RELEASE APPLICATION <br /> Greotness grows her � fAf nC,A 107ZFO <br /> PF1�11Tl5CAY:E9 1 <br /> �d EHD LOG NUMBER: <br /> APPLICANT: Abby Racco 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: abbV@logelodi.Corn <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 APPLICANT ,4ZIA/ rP�rr DATE 10-9-17 <br /> 1. List up to ten addresses in thin space below. Address ranges WILL NOT be accepted. Select the type(s)of files from the <br /> list below by checking the appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138,mail to the <br /> address indicated below,or email to jnfono-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. n / <br /> Future file reviews by the same applicant may require a$152 deposit prior to review. v` <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 to <br /> ENVIRONMENTAL FILE ADDRESS 1© a 2' <br /> HEALTH DEPARTMENT ( p <br /> (Specific addresses only,address ranges will not be accepted)) . EHD USE <br /> FILES ONLY <br /> Underground Tank(UST) Street# Street Name City g 1 <br /> f <br /> Cleanup Site(LOP) ' ❑CONSUMER <br /> Other Cleanup Site(Non-LOP) 25100 S. Kasson Rd. Tracy <br /> i Hazardous Waste ;Gwi&. j.. <br /> Tiered Permitted Facility P 23500 S. Kasson Rd. Tracy <br /> Aboveground Tank 0.1-AN 7r n S <br /> UST (Monitoring/Remov 11 n 1 ib <br /> Hazardous Materials 25001 S. Kasson Rd. Tracy nSj-' <br /> Spill/Release Response <br /> ❑Solid Waste Facility/Vehicle 4 25834 S. Kasson Rd. Tracy jf+ rfn <br /> ❑ Food Facility , 1 <br /> El Pool/Spa ({I'Yt`Foi.rff� O E '>4S <br /> ❑ Dairy 5 27057 S. Bird Rd. Tracy <br /> ❑ Land Use Application Sites Housinc <br /> Septic Pumper Truck/ <br /> Yard/Chemical Toilets <br /> ❑Wastewater Treatment Plant CUPA <br /> Housing Abatement T AST/HM/HW <br /> Motel/Hotel <br /> COP <br /> Chicken Ranch/Dog Kennel A <br /> g UST <br /> Medical Waste Facility <br /> Tattoo/Body Piercing ❑SOLID WwarE <br /> Waste Tire g <br /> Complaint <br /> ❑ Other(Please Specify): ❑Accouemp a <br /> 10 <br /> ***BOXED AREA-Er(HD USE ONLY*** <br /> 10-q-0-t - F-MN Qy i7o 0.,WW'-' St r y✓tF t - ' G �- ` L k .9rV CCj-- <br /> ❑ Records provided by Staff-PPR Complete. staff Name: aHo 4e-0s <br /> 1868 E. Hazelton Avenue l Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />