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To: Page 5 of 5 2016-06-06 14:43:15 (GMT) 18007249178 From:EcoSure HDI <br /> t7A kt` t rr: <br /> EHD LOG NUMBER <br /> IyE°'"> ( SAN JOAQUIN COUNTY <br /> �� � ' � <br /> JUN b 6 2016 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> NVIRQh?4Ef!TAL HE4Tf-Aephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> �- ?EP.P,4lTr3ER\10ES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT* FcaSiukert BUSINESSIAGENCY: Ecolab <br /> ADDRESS: 1601 West Diehl Road CITYISTATE/ZIP: Napervll 11-60563 <br /> PHONE (1): 630-305 2117 PHONE (2): FACSIMILE: 800a24-9178 <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 PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 06/06/2D16 <br /> Electronic Information: ❑ List ❑ Map—Description: <br /> FILE ADDRESS <br /> --- ---- — EHO).1SEONLY <br /> Street# Street Name City <br /> 1, 2442 West Kettleman Lane Lodi <br /> 2, 3D60 North Naglee Road Tracy Lk er/ulit 1 <br /> 3• 2262 Danlels5treet Manteca `{ Unit <br /> 4• 1230West Kettleman Lane Lodi ❑ Unit 2H <br /> 5. 3120 iNaglee Road Tracy <br /> 8. 353 West Louise Avenue Manteca Unit 3 <br /> Illiho 7• 2339 (Hammer Lane Stockton Unit <br /> 8. SITE MITIGATION <br /> 9, <br /> 10. ❑Unit 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 ❑SOLID WASTE FACIUTYIVEHICLE <br /> ❑OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> ❑UNDERGROUND TANK(MONITORINGIREMOVAL) x❑FOOD FACILITY ❑DAIRY <br /> ❑ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATERTREATMENT PLANT <br /> ❑HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARD/CHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOL/SPA ❑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 u0 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 /> ❑ Records provided by Staff-PPR Complete. staff Name: <br /> EHD 46.06 71'1/15 <br /> Received Time Jun. 6. 2016 7:42AM No. 0836 <br />