Laserfiche WebLink
DATE RECEIVED EHD LOG NUMBER <br /> SAN .IOAQUIN COUNTY �.r( <br /> CENE ENVIRONMENTAL HEALTH DEPARTMENT eA` q <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> JAN 13 2,(,jBTelephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> PERJM[T/SERVllfARMy WOODSNOA/TERRACON <br /> APPLICANT: BUSINESS/AGENCY: <br /> ADDRESS: 902 INDUSTRIAL WAY CITY/STATE/ZIP:_LODI, CA 95240 <br /> PHONE(1): 209-367-3701 _ PHONE (2): FACSIMILE:_209-333-8303 <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 TKWOODS(a-)TERRACON.COM DATE 01/12/2016 <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS <br /> EHD USE ONLY <br /> Street# Street Name City <br /> 1. 6484 N. WAVERLY ROAD LINDEN 5T, 5T 40 <br /> 2. 8020 N. WAVERLY ROAD LINDEN M UA40tl CO ❑❑unit 1 <br /> 3. aclit 2 <br /> 4. ❑Unit 2H <br /> 6. -Unit 3 <br /> 7. t Unit4 <br /> 8. la SITE MITIGATION - <br /> 9. <br /> 10. nit 5 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ❑UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY r❑XSOLID WASTE FACILITYNEH LE '.'O� <br /> 71OTHER CLEANUP SITE(NON-LOP) Q HOUSING ABATEMENT YJ WASTE TIRE LI �7'Q� t( ^t / <br /> Q UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACIU Y - [I DAIRY Lt4) t- I-z7- 10 <br /> 0 ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> ❑HAZARDOUS WASTEIHAZARDOUS MATERIALS C C ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> [/]TIERED PERMITTED FACILITYpt, ❑POOLISPA Z LAND USE APPLICATION SITFS <br /> ❑TATTOOIBODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) Well and Septic <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING fforl1 St address <br /> only <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropnate <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. <br /> Future file reviews by the same applicant may require a$130 deposit prior to review. ***BOXED AREA-EHD USE ONLY*** <br /> -Z7- 35 4 l ,-- &L ld -J12 051 L!l - r42 td i. <br /> r� <br /> ❑ Records provided by Staff-PPR Complete. staff Name: <br /> EHD 46-66 711115 <br />