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r <br /> SANJOAQUINRECEIVQronmental Health Department <br /> —COUNTY-- APR I ? 201? PUBLIC RECORDS RELEASE APPLICATION <br /> • Greatness grans he FfiQ4apL \v <br /> pPIWIT. EHD LOG NUMBER: <br /> APPLICANT: Sadie Bodiford BUSINESS/AGENCY:Terraccn Consultants,Inc. <br /> ADDRESS: 50 Goldenland Court,Suite 100 CITY/STATE/ZIP:Sacramento,CA 95834 <br /> PHONE(1): 916-246-5080 PHONE(2):916-928-4690 FAX OR E-MAIL: sadie.bodiford@termmn.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 apointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT Sadie Bodlford electronic signature) DATE 4-17-2018 <br /> 1. List up to ten addresses in the space below. Address 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(a)sicehd.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. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From All to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT (Specific y 9 p ) EHD USE ONLY <br /> FILES addresses onlyaddress ran es will not be acre ted <br /> Q Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) WP <br /> P L]CONSUMER <br /> Q Other Cleanup Site(Non-LOP) y <br /> 8715 Grant Line Road West Trac ISP <br /> • <br /> Q Hazardous Waste iko Lk`7T 0 DAIRY <br /> ❑Tiered Permitted Facility 2 724, Grant Line Road East Tracy " P <br /> Q Aboveground TankE <br /> nx UST (Monitoring I Removal) PWS <br /> Q Hazardous Materials 0 <br /> Q Spill/Release Response 11 WATER QUALITY <br /> Ll <br /> Waste Facility/Vehicle 4 V /!(� <br /> Food Facility <br /> Pool I Spa SITE MITIGATION <br /> F] Dairy 5 <br /> Q Land Use Application Sites <br /> HOUSING <br /> Q Septic Pumper Truck I ` s <br /> Yard I Chemical Toilets <br /> n Wastewater Treatment Plant CUPA <br /> Housing Abatement 7 AST I HM I HW <br /> Motel/Hotel <br /> Chicken Ranch I Dag Kennel CUPA <br /> 8 UST <br /> Q Medical Waste Facility <br /> ❑Tattoo/Body Piercingouo WASTE <br /> waste Tire 4 9 <br /> Q Complaint N•� ` <br /> Other(Please Specify): ❑Accou"NG <br /> 10 <br /> f' ***BOXED AREA-EHD USE ONLY**** <br /> • L1-\ I- l�3- G r ll nT l AC V /rte: l ORRA .n :MCA A- 14 n+/1 <br /> 0 Records provided by Staff-PPR Complete. staff Name: EH114e-0e <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.corn <br />