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RECEIVED <br /> DATE RECEIVED <br /> �f1 7 SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> PRAY 3 O LUL -�,;Aef 5(4,,, ENVIRONMENTAL HEALTH DEPARTMENT �! <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 TV1� <br /> ONVI ON14 IGALF11" Telephone: (209)468-3420 Fax: (209)4640138 Web:www.sjgov.org/ehd <br /> • PEI�AIT r PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: TAMMY WOODS BUSINESSIAGENCY: TERRACON <br /> ADDRESS: 902 INDUSTRIAL WAY - CITY/STATEIZIP: LODI, CA 95240 <br /> PHONE(1): 209367-3701 PHONE(2): FAX OR E-MAIL: tkwoodsg-terracon.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 appointment date and time to review the requested records. <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$$1130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT v}j/��/ 4 /Al/�� g DATE 5-23-17 <br /> 1. List up to ten addresses in the space below. Select the type(s)of files from the list below 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 reviewwill 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$130 deposit prior to review. <br /> Electronic Information: ❑ List❑ Map—Description: <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS <br /> LESEHD USE ONLY <br /> Z UNDERGROUND TANK(UST) Street# Street Name City <br /> CLEANUP SITE(LOP) <br /> ®O1HER CLEANUP SITE(NON-LOP) t 224 Main Street Lodi ❑CONSUMER <br /> • ®HAZARDOUS WASTE I DIO ❑DNW <br /> ®a TIERED PERMITTED FACILITY 7 532 Lockeford Street Lodi <br /> ® 1 <br /> ABOVEGROUND TANK <br /> ®UST (MONITORING/REMOVAL) <br /> PWS <br /> ®HAZARDOUS MATERIALS B <br /> ®SPILURELEASE RESPONSE <br /> r]SOLID WASTE FACILITY/VEHICLE 4A'i/EYRduaury <br /> ❑FOOD FACILITY <br /> ❑POOL/SPA <br /> ❑DARY 5 SITE MITIGATION <br /> LAND USE APPLICATION SITES <br /> SEPTIC PUMPER TRUCK! B ❑HOUSING <br /> YARD/CHEMICAL TOILER L <br /> ❑WASTEWATER TREATMENT PLANT MfcUPA �tyT <br /> ❑HOUSING ABATEMENT r <br /> ❑MOTEVHOTEL <br /> ❑CHICKEN RANCH/DOG KENNEL CUPA-HAZ-MAT <br /> e <br /> ❑MEDICAL WASTE FAiILITY <br /> ❑TATTOO/BODY PIERCING ❑SONG WASTE <br /> �I <br /> WASTE TIRE e <br /> Z COMPLAINT <br /> ❑OTHER(PLEASE SPECIFY): ❑ACCOUNTING <br /> 10 <br /> Specific Date Range of Information Requested: From to <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY8,00AM-5:00PM(EXCLUDING HOLIDAYS) <br /> • ***BOXED AREA-EHD USE ONLY*** <br /> 0 Records provided by Staff-PPR Complete. staff Name: <br />