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RKEJYE <br /> SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> JUL 3 1 2017 �},\ ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ENVIROWENTALKWH Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> PERMITfSERMCES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: TAMMY WOODS BUSINESSIAGENCY: TERRACON <br /> ADDRESS: 902 INDUSTRIAL WAY CITYISTATEIZIP: LODI, CA 95240 <br /> PHONE(1): 209-367-3701 PHONE(2): FAX OR E-MAIL: tkwoods@terracon.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 APPLICANT11114 ,(MS DATE 7-31-17 <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. V <br /> Future file reviews by the same applicant may require a $130 deposit prior to review. <br /> Electronic Information: ❑ List❑ Map—Description: <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES EHD USE ONLY <br /> ®UNDERGROUNC TANK(UST) Street# Street Name City <br /> CLEANUP SITE(LOP) <br /> 3515 Navy Drive Stockton <br /> OTHER CLEANUP SITE{N'GN-LOP <br /> ®HAZARDOUS WASTE <br /> f fff 'l✓r DAIRY <br /> ®TIERED PERMITTED FACILITY 2 <br /> Z ABOVEGROUND TANK <br /> UST{MONITORING I REMOVAL} <br /> PWS <br /> 3 <br /> ®HAZARDOUS MATERIALS <br /> SPILURELEASE RESPONSE <br /> WATER QUALITY <br /> SOLID WASTE FACILITY/VEHICLE 4 <br /> FOOD FACILITY <br /> ®POOL I SPA <br /> DAIRY 5 Ser MFiIGATION <br /> LAND USE APPLICATION SITES f <br /> HOUSING <br /> SEPTIC PUMPER TRUCK/ S <br /> YARD/CHEMICAL TOILETS <br /> ❑WASTEWATER TREATMENT PLANTCU�PA <br /> HOUSING ABATEMENT 7 C{I}r <br /> MOTEOHOTEL <br /> CHICKEN RANCH/Doc KENNEL CUPA-HAZ-MAT <br /> a <br /> MEDICAL WASTE FACILITY <br /> TATTOO/BODY PIERCING p SOLID WASTE <br /> ❑WASTE TIRE 9 <br /> ®COMPLAINT <br /> ®OTHER(P'LEASE SPECIFY): p ACCOUN7ING <br /> 10 <br /> WELL&SEPTIC PERMITS FOR#S 1 <br /> Specific Date Range of Information Requested: From to <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY•FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> -- —BOXED AREA-EHD USE ONLY*** <br /> L,\ <br /> CDO'ri4q2- <br /> CDC)01-4 20 In oe <br /> 0 Records provided by Staff-PPR Complete. staff Name: <br />