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IV 0 EHD LOG NUMBER <br /> SAN aJOAQUIN COUNTY <br /> SEP fl d 2015 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Ef�REiRONM ENTAL HEALTH <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sigov.org/ehd <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: TAMMY WOODS BUSINESS/AGENCY: NOA/TERRACON <br /> ADDRESS: 902 INDUSTRIAL WAY CITY/STATEIZIP: 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@TERRACON.COM DATE 09-11-15 <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS <br /> Street# Street Name City EHD USE ONLY <br /> 1. 4932 Pacific Avenue STOCKTON rJC CLem-LoPb <br /> 2. 5151 I Pacific Avenue I STOCKTON 4? 'Pt3 <br /> 3. 5110 I Pacific AvenueSTOCKTON ((�1� 7 ��. <br /> 4. I — k -(!� LtCw kftit 2jl <br /> 5 ❑Unit 2H <br /> 6. nn�le9. ci�i1e� cel Cape// <br /> 7. <br /> nn <br /> "`ov-) NIfnit3 <br /> M/Lnit4 <br /> 9 SITE MITIGATION <br /> 10. <br /> v Unit 5 <br /> Specific Date Range of Information Requested: From ALL to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> RI UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY IX SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT `(X WASTE TIRE <br /> I UNDERGROUND TANK(MONITORING/REMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> I�ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL Id WASTEWATER TREATMENT PLANT <br /> HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCK/YARDICHEMICAL TOILETS <br /> �f TIERED PERMITTED FACILITY ❑POOLISPA C4 LAND USE APPLICATION SITES <br /> LJ TATTOOIBODY PIERCING 13�COMPLAINT/RESPONSE 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 uo 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 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 /> t7c�too 1171 (�' <br /> �7 0No1fICAV, r,�Ju1tJ [I v , <br /> 5 S11a P 'L vl?. tax 4[ die lm/' SISI &,a Clio pactptL Aoz t1l�'Ued �5— �uc� Va. k t c0. <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> EHD 4806 <br /> 711115 <br />