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SITE INFORMATION AND CORRESPONDENCE_FILE 1
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0001333
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SITE INFORMATION AND CORRESPONDENCE_FILE 1
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Entry Properties
Last modified
1/29/2020 11:44:28 AM
Creation date
1/29/2020 11:16:06 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
FILE 1
RECORD_ID
PR0001333
PE
2950
FACILITY_ID
FA0004067
FACILITY_NAME
CHEVRON SERVICE STA 9-4183 (INACT)
STREET_NUMBER
236
Direction
N
STREET_NAME
HAM
STREET_TYPE
LN
City
LODI
Zip
95242
APN
03710028
CURRENT_STATUS
02
SITE_LOCATION
236 N HAM LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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From:Marcus H. Bole & Associates 530+633+0119 0413r'�08 16:14 . #009 P.001 <br /> DATE.RECEIVED - EHD LOG NUMBER <br /> Ho <br /> FC E WEE,DU SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue,3td Floor, Stockton, CA 95202-2703ehd Af R 3 0 2008 Telephone:(209) 458-3420 Fax:(209)464-0138 Web:www.sjgov.o <br /> ENVIRCNNM IaHEALTH <br /> N <br /> n PUBLIC RECORDS RELEASE APPLICATION <br /> PEP - . <br /> APPLICANT: I t7 BUSINESS/AGENCY: St <br /> ADDRESS: 0 � ,- <br /> PHONE(1):S�ilq 63 3 r0// PHONE(2): Q/j�-,—;7Y.7 4-�10 FACSIMtLE.S'?0 - li•33—p/ <br /> TENTATIVE`APPOINTMENT DATE. 10/" / Thi S Time: <br /> (Please allow*10 business days from dale of application submittal-"Tentative only-must be confirmed) <br /> f�I . <br /> CHECK BOX TO EXPEDITE REQUEST-$95-00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSH <br /> SIGNATURE OF APPLICANT DATE ' <br /> Electronic Information: []List❑ Map—Desc Iption: <br /> FILE ADDRESS EHD USE ONLY <br /> Street;N Street Name City ❑ Unit 1 <br /> 1. -1310 <br /> �• ✓rG*i�i QAOldel Lp .STa ❑ Unit2 <br /> 4. Unit 3 <br /> nit 4 <br /> [77. <br /> 469 <br /> ` ❑ Unit S <br /> 9. Off-- <br /> ❑ Unit S <br /> 1 t}. <br /> Specific Date Range of information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FIDS <br /> "NDERGROUND TANK(UST)CLEANUP SITE(LOP) E3 HOUSING ABATEMENT 13 SOLID WASTE FACILrN/VENICLE <br /> ER CLEANUP SITE(NON-LOP) 13 FOOD FACILITY ❑WASTE TIRE <br /> FVDERGROUNO TANK(MON[TORINGIREMOVAL) 11 DOG KENNEL Q DAIRY <br /> VARDOUS WASTE GENERATOR 0 CHICKEN RANCH 13 WASTEWATER TREATMENT PLANT <br /> C1 TIERED PFRMITTED FACILITY 13 MOTELIHOTEL 0 PUMPER TRUCKIYARDICHEMTOILETS <br /> 0 TATToo1BODY PIERCING 13 POOLISPA 17 LANn USE APPLICATION SITES <br /> 1--3 MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 8:00 AM-S:OOPM - EXCLUDING HOLIDAYS. <br /> 1. List up to ten 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(2091464-0138 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 pm will be processed the next business clay. <br /> 2. 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 behold 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 fife 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$95.00 deposit prior to review. <br /> EHD USE ONLY <br /> ENP S8g6 8l13�1006 <br /> ► i <br />
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