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SAN JOAQWCEIVED Environmental Health Department <br /> —COU NTY—FEB 12 2018 awd PUBLIC RECORDS RELEASE APPLICATION <br /> • eatncss gro s nuc, H 13 <br /> ENVIRONMENTALFERMIERWBEALTH EHD LOG NUMBER: vv�J <br /> APPLICANT: Tamara Woods pERA�4TiSfftdf� <br /> BUSINESS/AGENCY:_TerraCOn <br /> ADDRESS: _902 Industrial Way CITY/STATEIZIP:_Lodi CA 95240 <br /> PHONE(1): _209-269-8586 PHONE(2): FAX OR E-MAIL:tkwoods@terracon.com <br /> Please allow 1U business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an annointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT , <br /> ).�� DATE 2-12-18 <br /> 1. List up to ten addresses in the space peN. <br /> ow. aaress ranges WILL NOT be accepted. Select the type(s)of files from the <br /> list below by checking the appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138,mail to the <br /> address indicated below,or email to info ansicehd com Applications received after 3:00 pm will be processed the next <br /> business day. <br /> 2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted below. <br /> 3. 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 /> 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$152 deposit prior to review. f <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) Z 2 <br /> Electronic information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From to !1 <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS !�..US(6c 1 2-13 <br /> FILES (Specific addresses only,address ranges will not be accepted) EHD USE ONLY <br /> ,['Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) /) U4f- CONSUMER <br /> Other Cleanup site(Non-LOP) ' 330 I Kettleman Lane I Lodi Lo �y <br /> n iAvtO° A/0 CQ <br /> ZHazartlous Waste U + pC� Q nAIRY <br /> ❑Tiered Pennitted Facility z 100 I W. Lodi Avenue I Lodi <br /> to �G <br /> E]Aboveground Tank SM Fir•-rw+" L'1 NO�'�WI <br /> ZIUST (Mcnitoring I Remomt) 0 u S 1 p PWS <br /> ❑Hazardous Materials 3 420 S. Pleas=AvenueST• p�i N��� <br /> 7 Spill/Release Response -37 <br /> / f- <br /> ❑ 4 f� I U�l��fll/ Z�IQ WATER OeALrt <br /> Solid Waste Facility/Vehicle E25251S. <br /> enue Lodi ! I fit( •' <br /> ❑Food Facility ' NW NSA N�'W <br /> ❑Pool/Spa r^p SITE MMGAno" <br /> ❑Dairy 6 ns Street I Lodi LO ,,ryte <br /> ❑Land Use Application Sites M 5 �+ NJ L0 <br /> ❑septic Pumper Truck/ 6 Nm t tLf'i ❑HOUSING <br /> Yard/Chemical Toilets 902 industrial Way N•f •Lodi G//n <br /> ❑Wastewater Treatment Plant G U ,r,.� CUPA <br /> Housing Abatement r 420 Kettleman Lane Lodi ;//�l AST/HM/HW <br /> ❑Motamotel t0� NW 11M u W� <br /> F1 Chicken Ranch/Dog Kennel -5 UPA <br /> F1 Medical Waste Facility 3 UST <br /> b`+ i-lW Cil <br /> ❑Tattoo/Body Piercing Vor o t4 �Souo WASTE <br /> r_1 comp)aste Tirint a 514 I Kettleman Lane N • •Lodi, NO U9-Tev f' <br /> ✓J`'ompiainl �i <br /> ❑Other(Please Specify): <br /> ,a 1025 IIndustrial WayLodi �"-'� u�' oA"°°Nr."° <br /> "*BOXED AREA-EHD USE ONLY"` <br /> • e 2 2.•I�-1 -�,-c-;Ie� A ts�;,.d ruz:� cE �„ .�rtiel aF dew c,�.,\ � z f; �'�. k',: b-- <br /> -t L!a 0 yq <br /> Y r iw.1"" <br /> ❑ Records provided by Staff-PPR Complete. an Nama; ` eHoaa-lie <br /> ' )y I�j /n✓1 In �t <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3 0 1 p 2(39' 4-6138 I www.sjcehd.coAJm • <br />