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DATE RECEIVED EHD LOG NUMBER
<br /> SAN �IOAQUIN COUNTY
<br /> ENVIRONMENTAL HEALTH DEPARTMENT
<br /> 111 111 1868 East Hazelton Avenue, Stockton, CA 95205-6232 ♦ `
<br /> �yl a Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd `
<br /> PUBLIC RECORDS RELEASE APPLICATION �i ,
<br /> APPLICANT:Gene Olson BUSINESS/AGENCY:Neil O.Anderson&Associates
<br /> ADDRESS: 902 Industrial Way CITY/STATEIZIP:Lodi,CA 95240
<br /> PHONE(1): 209-747-0640 PHONE(2):209-367-3701 FACSIMILE:209-333-8303
<br /> TENTATIVE*APPOINTMENT DATE: Time:
<br /> (Please allow 10 business days from date of application submittal-"Tentative only-must be confirmed)
<br /> X CHECK BOX TO EXPEDITE REQUEST:$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS
<br /> SIGNATURE OF APPLICANT 4e44- t0_ft/ DATE December 5,2013
<br /> Electronic Information: ❑List❑ Map—Description:
<br /> FILE ADDRESS EHD USE ONLY
<br /> Street# Street Name City Elunit 1
<br /> �U 1— 1. 19400 N.Hyry 99 //Acampo
<br /> 2• I J` LCiN ce, i( LI Unit
<br /> 3.
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<br /> 6. I I / i (1 ❑Unit 4
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<br /> 8. / J ❑Unit 5
<br /> 9. I/
<br /> 10. !!) ( , rn 4)f_ '�ilYl;a((- � r+ \I-\U ,Li� /),I %)� ❑unit e
<br /> Specific Date Range of informalioh RequeatedC rom ` V
<br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES U
<br /> ❑UNDERGROUND TANK(UST)CLEANUP SITE(LOP) - ❑MEDICALWASTE FACILITY ❑SOLID WASTE FACILITYNE ICLE rr
<br /> F1 OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE !)j� 1 9/�t/fl(�_
<br /> fUr UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY U94 )ce
<br /> ABOVEGROUND TANK [-]CHICKEN RANCHIDOG KENNEL ❑WASTEWATERTREAT6IENT PLANT
<br /> ❑HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDiCHEMICAL TOILETS
<br /> ❑TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES
<br /> ❑TATTOOIBODY 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 un to ten addresses in the space above. Select the type(s)of flies 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-for additional assistance with file addresses,contact the EHD. Applications received after
<br /> 3:00 pm will be processed the next business day.
<br /> 2. 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 /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may be
<br /> submitted when the file is available.
<br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the ex erase of the a licant.
<br /> Future file reviews by the same applicant may require a$125 deposit prior to review. BOA{,• E DAaO x �x i � -� x -�- ....,. .. <:.:k '„k S,_5f .mss "+?5:,,. •x' � .�`<vt(.#.i;+ .�'a.,�:,'
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