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DATE RECEIVED EHD LOG NUMBER M <br /> SAN J®AQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: WWW.sioov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Terry Nephew BUSINESS/AGENCY: Kleinfelder Inc. <br /> ADDRESS: 5125 N. Gates Ste 102 CITYISTATE/ZIP: Fresno, CA. 93722 <br /> PHONE (1): (559)577-1459 PHONE (2): (559) 647-3842FACSIMILE: 5594425081 <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 REQUUE i-$130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESg DAYS <br /> SIGNATURE OF APPLICANT C DATE�! <br /> Electronic Information: List Map— Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City <br /> 1 9000 West Tumer Rd. Lodi nt it r4 <br /> 2. 240 est Turner Rd. Lodi J 1 �l <br /> ��% 11- " fMrur�'I Unft2 <br /> 3. 401 North Mills Lodi- <br /> 4. <br /> odi 4. 838 Mokelumne j Lodi c� /:&It a, <br /> 6. <br /> Unit 4, <br /> 7. <br /> 8. <br /> Units <br /> 9. <br /> 10. <br /> Unite <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> JOUNDERGROUND TANK(UST)CLEANUP SITE(LOP) MEDICAL WASTE FACILITY SOLID WASTE FACILITYIVEHICLE ,CD <br /> THEIR CLEANUP SITE(NON-LOP) HOUSING ABATEMENT WASTE TIRE �i(25 <br /> I <br /> NDERGROUND TANK(MONTORINGIREMOVAL) FOOD FACILITY DAIRY <br /> ABOVEGROUND TANK CHICKEN RANCHI DOG KENNEL WASTEWATER TREATMENT PLANT Ii-_II''�I I <br /> HAZARDOUS WASTE/HAZARDOUS MATERIALS MOTELIHOTEL PUMPER TRUCKIYARDICHEMICAL TOILETS. <br /> TIERED PERMDTED FACILITY POOLISPA LAND USE APPLICATION SITES <br /> TATTOO/BODY PIERCING COMPLAINTIRESPONSE RECORDS OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE 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 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 mall 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 <br /> (10)days after receipt of application.The fifes 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 applicant may require a$130 deposit prior to review.—BOXED AREA-EHD USE ONLY`°* <br /> 'f l . C 1 P ") , - -r1 t-U) c(- 'f Ol l'vl. <br /> - <br /> :'1`Tiv <br /> Ehu 48-0e <br /> BB/etn4 <br />