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0rag;125410340 04:54:30 p.m. 07_11-2016 1 /1 <br /> lZ <br /> ray NE <br /> D, <br /> r-.;: DATE;M' M—I SAN JOAQUIN COUI4TY EHD LOG NUMBER <br /> r JUL y , �� ENVIRONMENTAL HEALTH DEPARTMENTfr�( <br /> 1868 East Hazelton Avenue, Stockton,CA 95205-6232 <br /> • .Telephone: (209)466-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> ENVIRONMERTAL HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> PERU it col r.. <br /> APPLICANT: Conor Darrow BUSINESS/AGENCY: RPS GaiaTech <br /> ADDRESS: 135 S LaSalle Ste 3500 CITY/STATErzIP: Chicago, IL 60603 <br /> PHONE(1): 312-262-4387 PHONE(2): FAX OR E-MAIL: conor darrowarpsgrouo 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 /> ❑ 6HECK90X.T0 EXPEDITE REQUEST-$130 FEE(CASH OR CHEOKONLY),, REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT Conor Darrow DATE 7/11/2016 <br /> 1. List up to ten addresses in the space below. Select the types)of files from the list below by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(2091 464-0138 or mall 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 Flies 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. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 6:00 AM-5;ODPM(EXCL UDINC HOLIDAYS) <br /> Electronic information: ❑ List❑ Map-Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL <br /> HIIALTH_AEFARtMENt FILE ADDRESS E D �fSELY <br /> FILES <br /> ®UNDERGROUND TANK(LIST) street# Street Name city <br /> CLEANUP SITE(LOP) 850 Thurman.St Lodi ❑CDNBUMER <br /> OTHER CLEANUP SUE iNON-LOP) <br /> ®HAZARDOUS WASTE <br /> DAIRY <br /> ®TIERED PERMITTED FACILITY z 500 Beckman P.oad - Lodi <br /> �y ABOVEGROUND TANK <br /> ®UST(MONITORING/REMOVAL) C2 PWS <br /> ®HAZARDOUS MATERW.s S <br /> ®SPILURELEASE RESPONSE <br /> SOLID WASTE FACILITY/VEHICLE y - <br /> WATERQUAUTY <br /> ❑FOOD FACILITY <br /> ❑POOL/SPAfrE MIRGRON <br /> DAIRY 6 <br /> ®LAND USE APPLICATION SITES <br /> ❑SEPTIC PUMPER TRUCK/ 6 ❑HOUSING <br /> YARD/CHEMICAL TOILETS <br /> ®WASTEWATER TREATMENT PLANT <br /> "PA <br /> ❑HOUSING ABATEMENT T Fir <br /> ❑MOTEUHOTPL <br /> ❑CHICKEN RANCH/DOG KENNEL OUPA U15T <br /> e <br /> ❑MEDICAL WASTE FACILITY --- _ <br /> ❑TATTOOMODY PIERCING <br /> ❑WASTE TIRE S SOLIOWASTE <br /> 'COMPLAINT <br /> OTHER(PLEASE SPECIPY): - <br /> 'D �ACCWM1TNG <br /> `••BOXED AREA-EHD USE ONLY`•• <br /> LO Records provided b Staff-PPR Complete. Staff Name: <br /> Received T!Fme Jul., 11. 2016 2: 54PM No. 0957 <br />