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EHD LOG NUMBER <br /> DATE RECEIVED SAN JOAQUIN COUNTY 9)%� 3/i fj�" ENVIRONMENTAL HEALTH DEPARTMENT <br /> I 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> P ' PUBLIC RECORDS RELEASE APPLICATION <br /> �1 <br /> APPLICANT: Erica Burkert BUSINESS/AGENCY: ECOLAB <br /> ADDRESS: 1601 West Diehl Road CITY/STATE/ZIP:Naperville IL 60563 <br /> PHONE (1): 630-305-2117 PHONE(2): FACSIMILE:-800-724-9178 <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 P OCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 07/23/2015 <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City .❑UUnitl <br /> 1• Chili's 2262 Daniels Street Manteca 30 <br /> 2, Red Lobster 2283 West March Lane Stockton t ❑Unit <br /> 3. IHOP 1230 West Kettleman Lane Lodi `1 <br /> 4• [HOP 3120 Na lee Road Trac ❑Unit �J�I <br /> 5• Little Caesar's 2339 Hammer Lae Stockton <br /> 6. ❑ Unit4 <br /> 7. r. <br /> 8• itl - l ❑ Units <br /> 9. <br /> 10. ❑ unit6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ❑UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILITYNEHICLE <br /> ❑OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> ❑UNDERGROUND TANK(MONITORINGIREMOVAL) F&]FOOD FACILITY ❑DAIRY <br /> ❑ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> ❑HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATroo/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 /> b0x(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 /> 6�A/Z <br /> ❑ Records provided by Staff-PPR Complete. staff Name: <br /> EHD 48-06 08101114 <br />