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HLULIVED <br /> DATE EIVED aA 0 SAN JOAQUIN COUNTRUSH EHD LOG NUMBER <br /> 19 01F I-10t 5'451 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> &V1/iRONMENi/lL HEAf_TH 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> PEPiMITJSERVt" Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: TAMMY WOODS BUSINESSIAGENCY: TERRACON <br /> ADDRESS: 902 INDUSTRIAL WAY CITYISTATEIZIP: LODI,CA 95240 <br /> PHONE(1): 209367.3701 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 reviewthe requested records. <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT1//W 4w, /W, e5�D DATE 01-03-2017 <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 reviewwill 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 Wll 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. <br /> Electronic Information: ❑ List❑ Map—Description: <br /> ENVIRONMENTAL 10 ti ,eco 1 CD, i� i-ZCI-1 <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> FILES EHD USE ONLY <br /> Z UNDERGROUND TANK(UST) Street# Street Name City <br /> CLEANUP SITE(LOP) )Op <br /> Z OTHER CLEANUP SITE(NON-LOP) 1 24511 N.ST RT 99 ACAMPO Poll I <br /> E03 CONSUMER <br /> Z HAZARDOUS WASTE `N J //� ❑DAIRY <br /> ®TIERED PERMITTED FACILITY 2 24327 N.ST RT 99 ACAMPO r <br /> ®ABOVEGROUND TANK PWS <br /> ®UST (MONITORING I REMOVAL) <br /> HAZARDOUS MATERIALS a 24323 N.ST RT 99 ACAMPO <br /> ® c.*6M-F-A000ti345 <br /> ZSPIWRELEASE RESPONSE <br /> SOLID WASTE FACILRY I VEHICLE u� rNO (,Q� WATER QUALITY <br /> ® 4 24355 N.ST RT 99 ACAMPO <br /> \\ ❑FOOD FACILITY <br /> L� ❑POOL I SPA N�t to QPr <br /> ❑DAIRY s 24155 N.ST RT 99 ACAMPO �fl n� L SITE MRIGAPON <br /> ❑LAND USE APPLICATION SITES WN <br /> ❑SEPTIC PUMPER TRUCK s23987 N.ST RT 99 ACAMPO 1&411Z <br /> UID ❑HOUSING <br /> � /}YARD I CHEMICAL TOILETS .�y'06 <br /> ❑WASTEWATER TREATMENT PLANT LNE M CUPA <br /> ❑HOUSING ABATEMENT r FA OnOO-7 ✓ <br /> ❑MOTEIIHOTEL FA It 2 to✓ VS <br /> ❑CHICKEN RANCH I DOG KENNEL WPO-HM1Z=MAT <br /> ❑MEDICAL WASTE FACILITY s <br /> ❑TATTOO/BODY PIERCING - $ouo WASTE <br /> Z WASTE TIRE y <br /> Z COMPLAINT <br /> Z OTHER(PLEASE SPECIFY): ❑ACCOUNTING <br /> WELLAND SEPTIC PERMITS 1e <br /> For#1,283 ADDRESS ONLY <br /> dip 0 <br /> Specific Date Range of Information Requested: From to <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:o0PM EXCLUDING HOLIDAYS <br /> •"BOXED AREA-EHD USE ONLY* <br /> , <br /> ,2 co l 5 q Z tAW ti' <br /> 0 Oa L <br /> 0 Records provided by Staff-PPR Complete. Staff Name: <br />