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11111111111111111117/13/2015 11 : 10 : 10 AM -050 Terracon Fax Server PAGE 1 OF 1 <br /> IN V <br /> 1■ON <br /> ■ D` EHD LOG NUMBER <br /> IED SAN JOAQUIN COUNTY <br /> Ia ENVIRONMENTAL HEALTH DEPARTMENT <br /> JUL 13 2615 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd 51WI <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Tammy Woods BUSINESS/AGENCY: NOA/Terracon <br /> ADDRESS: 902 Industrial Way CITY/STATE/ZIP: Lodi, CA 95240 <br /> PHONE(1): _209-367-3701 - PHONE(2): FACSIMILE: 209-333-8303 <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 appointment date and time to review the requested records. <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT Tammy Woods (tkwoods@terracon.com) DATE 07/13/2015 <br /> Electronic Information: ❑ List ❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑Unit 1 <br /> 1• 7700 ! Moreland Street Stockton <br /> �/ 2. s '��� - J ✓( �? 1� i `) ��. J �� t-Vin L LJv��`1/tih C® Unit 2 <br /> 3. <br /> .—D'Unit 3 <br /> V SITE MITIGATION <br /> 1Z f <br /> 6. ��' co. <br /> 8. ��� (� E Unit I) 1� <br /> 9. <br /> 10. <br /> Q oe Unit <br /> Specific Date Range of Information Requested: From to E <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> _X UNDERGROUND TANK(UST)CLEANUP SITE(LOP) n MEDICAL WASTE FACILITY n SOLID WASTE FACILITY[VEHICLE <br /> f%OTHER CLEANUP SITE(NON-LOP) Nj HOUSING ABATEMENT I]k NASTE TIRE <br /> FX UNDERGROUND TANK(MONITORING/REMOVAL) Ff FOOD FACILITY LJ DAIRY <br /> AXI ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> XI HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDIC HE MICAL TOILETS <br /> Il TIERED PERMITTED FACILITY n POOLISPA ®LAND USE APPLICATION SITES <br /> LJ TATTOOIBODY PIERCING ®COMPLAINTIRESPONSE RECORDS LJ 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 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(209)464-0138 or mail to the address indicated above. Address <br /> ranges will not be accepted.Applications received after 3:00 pm will be processed the next business day. <br /> 2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted above. <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$125 deposit prior to review. ***BOXED AREA-EHD USE ONLY*** <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> 5/11115 <br /> Received Time Jul. 13. 2015 9:09AM No. 9134 <br />