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08/20/2014 16:37 2093338303 LODI DOWNSTAIRS PAGE 02/02
<br /> DATE RECEIVED . EHD LOG NUMBER
<br /> � �E�
<br /> I V � SAN JOAQUIN COUNTY
<br /> tl � ENVIRONMENTAL HEALTH DEPARTMENT
<br /> AUG 2 2 2014• 1868 East Hazelton Avenue, Stockton, CA 95205-6232
<br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd
<br /> ENVIRONMENTAL
<br /> SEav►C ES PUBLIC RECORDS RELEASE APPLICATION
<br /> APPLICANT: Heather Shaddox BUSINESS/AGENCY: Neil O. Anderson&Associates
<br /> ADDRESS: 902 industrial Way CITY/STATEIZIP: Lodi,CA 95240
<br /> PHONE (1): 209-367-3701 PHONE (2):209-747-1000 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 /> ❑ CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS
<br /> SIGNATURE OF APPLICANT DATE August 21, 2014
<br /> I,
<br /> Electronic Information: ❑ List❑ Map—Description:
<br /> FILE ADDRESS EHD USE ONLY
<br /> Street 0 Street Name City
<br /> ElUnit 1
<br /> 1. 200 N. Beckman Road Lodi tL+3 11
<br /> 2. 880 E Victor Road Lodi _ � y _
<br /> /4
<br /> 2.
<br /> 3, 845 E, Pine Street Lodi
<br /> ---- tit)s 11�
<br /> 4. 900 `fid?ehe, E.Victor Road k Lodi 16Unit 3
<br /> S. 920 E.Victor Road Lodi
<br /> G. 873 E. Pine Street Lodi 4-2--�—_ unsca
<br /> 7. 861 E, Pine Street Lodi `
<br /> 8. 921 E, Pine Street Lodi - Q Unit 5
<br /> 9. 930 E.Victor Road Lodi
<br /> 10. 940 E.Victor Road Lodi Ic Unit 6
<br /> Specific Date Range of Information Requested: From to
<br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES
<br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) E:1 MEDICAL WASTE FACILITY 0SOU0 WASTE FACILITYNEHICLE
<br /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ®WASTE TIRE
<br /> Z UNDERGROUND TANK(MONITORING/REMOVAL.) ❑FOOD FACILITY E�1 DAIRY
<br /> ®ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL Z WASTEWATER TREATMENT PLANT
<br /> HAZARDOUS WASTE/HAZARDOUS MATERIALS ❑MOTELIHOTEI. ®PUMPERTRUCKNARDICHEMicALToILErs
<br /> ® TIERED PERMITTED FACILITY ❑POOL/SPA LAND USE APPLICATION SITES
<br /> ❑TATT00113ODY 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 tan addresses in the space above. Select the types) 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-for additional assistance with file addresses, contact the EHD. Applications received after
<br /> 3:00 pen 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 activaly 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 th®expense of the applicant.
<br /> 'r
<br /> LETO
<br /> Future file reviews by the same applicant may require a$125 deposit prior to review. �; .. +,r...._,.. ,.... .
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