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SITE INFORMATION AND CORRESPONDENCE_CASE 2
EnvironmentalHealth
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SITE INFORMATION AND CORRESPONDENCE_CASE 2
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Last modified
2/10/2020 5:49:18 PM
Creation date
2/10/2020 4:23:27 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
CASE 2
RECORD_ID
PR0545336
PE
3528
FACILITY_ID
FA0003776
FACILITY_NAME
KWIK SERV LODI BW 113*
STREET_NUMBER
420
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
06202042
CURRENT_STATUS
02
SITE_LOCATION
420 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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SANJOAQ(�DEIVED Environmental Health Department <br /> —COUNTY--FEB 12 2018 PUBLIC RECORDS RELEASE APP.}LIIICATIIONN <br /> ENVIRONMENTALHEALTH EHD LOG NUMBER: <br /> APPLICANT: Tamara Woods PE BUSINESS/AGENCY: Terracon <br /> ADDRESS: _902 Industrial Way CITY(sTATEIZIP:_Lodi CA 95240 <br /> PHONE(1): _209-269-8586 PHONE(2): FAX ORE-MAIL:tkWDods terracon.com <br /> Please allow 11.1 business gays from date of application submittal for the records to be available. <br /> Staff will contact you to arranae an annnintment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT <br /> it( ,y.,' „ DATE 2-12-18 <br /> 1. List un to ten addresses in the space Aelow. Ac a ess ranges WILL NOT be accepted. Select the types)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 infoC$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. ) l�� <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 to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT ( Ponly, g p <br /> FILES S eclfic addresses address ranges will not be accepted) EHD USE ONLY <br /> ,E 'Underground Tank(UST) Street# Street Name city <br /> Geanup Site(LOP) / f � ❑Ooutu.eR <br /> di o <br /> Lane man <br /> ttl <br /> • I eOther Cleanup Site(Non-LOP) 330 Ke <br /> yv q <br /> H tQ, <br /> gHazardcus Waste p DAIRY <br /> ❑Tiered Permitted Facility 2 100 W. Lodi Avenue I Lodl <br /> E]Aboveground Tank SM F1M rni LJ' <br /> ZIUST (Monitoring/Removal) ❑PWS <br /> Hazardous Materials <br /> ' 420 I S. Pleasant Avenue Lodi <br /> .8 Spill/Release Response M n 'n <br /> WATER OuAutt <br /> Solid Waste Facility/Vehicle 4 1 (W <br /> 820 I S. Cluff Avenue _Lodi ( C'D AM <br /> Food Facility `7M Hh IOW NS� <br /> Pool/Spa RISITE MITIGATION <br /> ❑Dairy 5 25251 S. Hutchins Street Lodi <br /> F Land Use Application Sites <br /> HousING <br /> Septic Pumper Truck/ s 902 1 industrial Way I Lodi <br /> Yard/Chemical Toilets h I-4M �: <br /> Wastewater Treatment Plant 6e.. , ,gyp{.t'( CUPA <br /> Housing Abatement , 420 1 Kettleman Lane Lodi l/"� AST/HM/HW <br /> MoteVHotel Lop, HW NM <br /> Chicken Ranch/Dog KennelTt i� UPA <br /> a 501 Kettleman Lane Lodi r Tt „ST <br /> Medical Waste Facility idN <br /> TattooBody Pleming SMID WASTE <br /> Waste Tire 9 514 Kettleman Lane Lodi <br /> ('Complaint M Ht✓�'+ h� <br /> Other(Please Specify): r11{p, ElAcccuurmG <br /> ,a 1025 Industrial Way Lodi -1,d 11W <br /> '*BOXED AREA-EHD USE ONLY" <br /> • A 2 �-I)-t� vvlc� A ( d rccr:� a( r,ea aE do C 'v l-i e4. 4?: t� <br /> ❑ Records provided by Staff-PPR Complete. staff Name: EH04eu6 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />
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