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----------- ------ <br /> --------------- <br /> -_% ­------------ ------------- ------- ....... ...... <br /> 06/03/2012 14:48 209333831 LODI DOWNSTAIRS PAGE 01/01 <br /> ■ <br /> ■ DATE RECEIVED SAN JOAQUIN COUNTY ! <br /> NOV III LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARJ <br /> RECEIVED 1868 East Hazelton Avenue, Stockton, CA 95205- 1 <br /> M2 <br /> JUIN 0 4 2012 Telephone: (209)468-3420 Fax: (209)464-0138 Web:Wv/W-sj9ov.org/ehdW Y3 <br /> ENVIRONMENTAL HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Tina Cheney <br /> ADDRESS: 902 Industrial Way BUSINESS/AGENey: Neil 0. Anderson & Assoc. <br /> CITY/STATE/zip: Lodi, CA 95249 <br /> PHONE(1): x09-747-0640 PHONE(2): — <br /> TENTATWE-APPOW—MENT DATE: FACSIMILE: 209-333-8303 <br /> (Please allow IObu-,Rlneasdays from—data—of�—lPplicat-'onsubmittal--'T(,nt—.tive, ly-m Time: <br /> ❑CHECK Box "Med <br /> ust b.confirmed) <br /> To EXPEDITE REQUEST-$125 FEE(CASK OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT Timc, <br /> ..v DATE June 4 2012 <br /> Electronic Information: List C1 map—Description: <br /> _Z <br /> Zion. r_1 <br /> FILL~ADDRESS EHD USE ONLY <br /> Street Stroat Name City <br /> 915 <br /> e Unit 1 <br /> Fi 1915 Moffat Blvd.—,— t —O/U I <br /> 2. 1937 ll Blvd, <br /> 3. —Manteca E/Unh 2 <br /> 4... 77- <br /> S. U <br /> 6. <br /> 7. <br /> .1 Unit <br /> 4 <br /> S <br /> 3 <br /> 6 <br /> -_7(_)T <br /> r7 <br /> 8. <br /> 9 9 <br /> 10. <br /> Specific Date III of information Requested: From dUnit 6 <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILES— to <br /> UNDERGROUND TAMP CLEANUP SITr.(LOP) HOUSING ABATEMENT SOLID WASTE FACILITY,(VEHICLrTo <br /> El OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY <br /> UNDERGROUND TANK(MONITORINGIRrMOVAL) ❑ DAIRY <br /> WASTE.TlFzr; <br /> HAZARDOUS WASTEGENERATOR DOG KENNEL <br /> 51 TIERED PERMITTED FACILITY CHICKEN RANCH 12 WASTEWATER TREATMENT PLANT <br /> 2 TATTOO/BODY PIERCING MOTELIHOTEL❑ 1K3 PUMPER TRUC KIYAR D/CHEMI CAL TOILETS <br /> N1 MEDICAL WASTE FACILITY F1 <br /> F1 COMPLAINT RECORDS 1�LAND USE APPLICATION S17-ES <br /> 1-1 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 Aim-5:00pil(EXCLUDING) <br /> HOLIDAYS) <br /> 1. List.,u�w ten�aqrespes In the sPsce above. Select the tyP@(S)of files from the list abode by checking the appropriate <br /> bOX(es). At leastonefile type MUST be selected. EM–to 1209)464-0139 he I C I_- <br /> ormail to the a ted a <br /> ranges will not be accepted-for additional assistancead Iress indicated Address <br /> 3:00 Pm will be PP-00essed the next business dawith file addresses,contact the III Applications received after <br /> 2. The Ell will notify the applicant if any EHD fill exist. An appointment for review will bl. <br /> days after receipt of application , confirmed approximately ten(10) <br /> should be scheduled accordingly. <br /> -y.The flies will be held for a maximum of five business days for review. Appointments <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new-application may be <br /> Submitted when trio file is available. <br /> 4. Any filo not returned In the same condition as released will be reorganized by EHD Staff at theexpenseof the aPPlIcant. <br /> Future file revIewei by the same applicant may require a$125 deposit prior to review. <br /> rHD U,4F-:ONLY <br /> EHD 4A-06 <br /> Received Time Jun. 4. 2012 4:37PM No, 0074 <br />