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08/20/2014 16:37 2093338303 LODI DOWNSTAIRS PAGE 02/02
<br /> DATE RECEIVED SAN JOAQUIN COUNTY EHD LOG NUMBER
<br /> RECEIVED ENVIRONMENTAL HEALTH DEPARTMENT
<br /> AUG 2 2 Z014 1868 East Hazelton Avenue, Stockton, CA 95205-6232
<br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.Sjgov.org/ehd +
<br /> ENVIRONMENTALHEP.LTH PUBLIC RECORDS RELEASE APPLICATION
<br /> ot:0hA1T1SE9VIC'FS .._.
<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: r Time:
<br /> (Please allow 10 business days from date of application submittal-°Tentative only-must be confirmed)
<br /> ❑ CHECK PDX To F_XPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS
<br /> SIGNATURE OF APPLICANT DATE August 21, 2014
<br /> Electronic IInformation: ❑ List❑ Map-Description:
<br /> FILE ADDRESS EHD USE ONLY
<br /> Street ff Street Name CityEl Unit 1
<br /> 1. 200 N. Beckman Road Lodi I L J l
<br /> 2. 880 E Victor Road Lodi �unIt 2
<br /> 3, 845 E. Pine Street Lodi — -_ _-�7Y"'f --_/ 1�• •-•'-•_.
<br /> 4. 900 Hoo'a E.Victor Road --k , r ,ff, ^ Lodi �b Unit 3`
<br /> 5. 920 E.Victor Road imp`'•• Lodi
<br /> G. 873 E. Pine Street Lodi
<br /> 7. 861 E. Pine Street Lodi `
<br /> 8. 921 E.Pine Street u- Lodi ❑Unit 5
<br /> 9. 930 - E.Victor Road Lodi
<br /> 10. 940 E.Victor Road Lodi 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 EISOLID WASTE FACILITY/VEHICLE
<br /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ®WASTE TIRE
<br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY DAIRY
<br /> ®ABOVEGROUND TANK ❑CHICKEN RANCHI DOG KENNEL WASTEWATER TREATMENT PLANT
<br /> HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ®PUMPER TRUCKIYARDIC14EMICAL TOILETS
<br /> ® TIERED PERMITTED FACILITY ❑POOLISPA LAND USE APPLICATION SITES
<br /> ❑TATT661BODY 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 tort 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-for additional assistance with file addresses, contact the EHD. Applications received after
<br /> 3:00 pnt will be processed the next business day.
<br /> 2. The EHD will notify the applicant if any EHD files exist. An appointment for review uvill 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 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 exponse of the applicant.
<br /> Future file reviews by the same applicant may require a$125 deposit prior to review. I�; eQ.;ED._JA "A o
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