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08/20/2014 16:37 2093338303 LODI DOWNSTAIRS PAGE 02/02
<br /> �( DjjSAN JOAQUIN COU ATE RECEIVED EHD LOG NUMBER
<br /> fl.ECEIVED �. �; �� �,�
<br /> ENVIRONMENTAL HEALTH D 1 T ELT
<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 HEALTH PUBLIC RECORDS RELEASE APPLICATION
<br /> APPLICANT: Heather Shaddox BUSINESWAGENCY: Neil O. Anderson &Associates
<br /> ADDRESS: 902 Industrial Way CITY/STATE/ZIP: Lodi,CA 95240
<br /> PHONE (1): 209-367-3701 PHONE(2):209-74.7-1000 FACSIMILE:209-333-8303
<br /> TENTATIVE"APPOINTMENT DATE: Time:
<br /> (Please allow 10 business days from date of application submittal-*Tentative only-must bo confirmed)
<br /> ❑ CHECK BOX TO RXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS
<br /> SIGNATURE OF APPLICANT DATE August 21, 2014
<br /> Electronic Information: ❑ List❑ Map--Description:
<br /> FILE ADDRESS EHD USE ONLY
<br /> Street 0 Street Name City
<br /> IZ1Unit 1
<br /> 1. 200 _ N.Beckman Road Lodi l
<br /> 2, 880 — E.Victor Road (—" Lodi _ _ __ �un_it 2_
<br /> 3, 845 — E. Pine Street jtl VJ -r Lodi
<br /> 4. 900 E.Victor Road Lodi Ej
<br /> 5. 920 � E.Victor Road ---- Lodi - - --- •- .--•�•( -^Unit_--3:-
<br /> c�- uJT
<br /> S. 873 E. Pine Street Lodi _ _ - [�Unit4
<br /> 7. 861 E. Pine Street F J Lodi `
<br /> 8. 921 E.Pine Street Lodi ❑Unit 5
<br /> 9. 930 — E.Victor Road -� Lodi
<br /> L10. 940 E.Victor Road nl Lodi — C� Ej unit s
<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 FACILITYfVEHICLE 440-1.4,
<br /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ®WASTE TIRE .Jt/�
<br /> UNDERGROUND TANK(MONiTORINGIREMOVAL) El Fool)FACILITY rC] DAIRY
<br /> ®ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL Z WASTEWATER TREATMENT PLANT
<br /> HAZARDOUS WASTE(HAZARDOUS MATERIALS ❑MOTELIHOTEI. ®PUMPER TRUCKNARDICHEMICAL TOILETS
<br /> ® TIERED PERMITTED FACILITY ❑POOLISPA Z 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 up to to addrosses 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-for additional assistance with file addresses, contact i he EHD. Applications received after
<br /> 3:00 pm will be processed the next business day.
<br /> 2. 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 rive business days for review. Appointments
<br /> should be scheduled accordingly.
<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 the file Is available.
<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$125 deposit prior to review.
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