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`DATE FzFCEIVED III SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd PUBLIC RECORDS RELEASE APPLICATION APPLICANT: Tina Chen EHD LOG NUMBER r BUSINESS/AGENCY: Neil O. Anderson & Associates ADDRESS: 902 Industrial Way CITY/STATE/ZIP: Lodi, CA 95240 PHONE (1): 209-747-0640 PHONE (2):209-367-3701 FACSIMILE: 209-333-8303 TENTATIVE* APPOINTMENT DATE: Time: (Please allow 10 business days from date of application submittal - *Tentative only - must be confirmed) ❑ CHECK BOX TO EXPEDITE REQUEST - $125 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS SIGNATURE OF APPLICANT Tina Cheney DATE October 8, 2013 Electronic Information: ❑ List ❑ Map — Description: FILE ADDRESS EHD USE ONLY Specific Date Range of Information Requested: From to ENVIRONMENTAL HEALTH DEPARTMENT FILES X UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ MEDICAL WASTE FACILITY X SOLID WASTE FACILITYIVEHICLE . X OTHER CLEANUP SITE (NON -LOP) ❑ HOUSING ABATEMENT ❑ WASTE TIRE CA C 4 X UNDERGROUND TANK (MONITORINGIREMOVAL) ❑ FOOD FACILITY ❑ DAIRY ' Q.J' -0) X ABOVEGROUND TANK ❑ CHICKEN RANCH/ DOG KENNEL ❑ WASTEWATER TREATMENT PLANT X HAZARDOUS WASTE/HAZARDOUS MATERIALS ❑ MOTEL/HOTEL ❑ PUMPER TRUCKIYARDICHEMICAL TOILETS X TIERED PERMITTED FACILITY ❑ POOLISPA ❑ LAND USE APPLICATION SITES ❑ TATTOO/BODY PIERCING ❑ COMPLAINTIRESPONSE RECORDS ❑ OTHER (PLEASE SPECIFY) WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) 1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checking the appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-0138 or mail to the address indicated above. Address ranges will not be accepted - for additional assistance with file addresses, contact the EHD. Applications received after 3:00 pm will be processed the next business day. 2. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten (10) days after receipt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may be submitted when the file is available. 4. Any file not returned in the same condition as released will be reorganized by END staff at the expense off the applicant. Future file reviews by the same applicant may require a $125 deposit prior to review. ***BOXED AREA ,EHD USE ONLY AM 100 100", Street # Street Name City ❑ Unit 1 1. 19400 N. Highway 99 Acampo1J° CUSP u�ak Acampo _ �❑ Unit 2 2. 19400 N. Highway 99 Frontage 3. 19501 N. Highway 99 Acampo Sd �,� a Ad'Unit 3 4. 5. Unit 4 6. 7. ❑ Unit 5 8. 9. ❑ Unit 6 10. Specific Date Range of Information Requested: From to ENVIRONMENTAL HEALTH DEPARTMENT FILES X UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ MEDICAL WASTE FACILITY X SOLID WASTE FACILITYIVEHICLE . X OTHER CLEANUP SITE (NON -LOP) ❑ HOUSING ABATEMENT ❑ WASTE TIRE CA C 4 X UNDERGROUND TANK (MONITORINGIREMOVAL) ❑ FOOD FACILITY ❑ DAIRY ' Q.J' -0) X ABOVEGROUND TANK ❑ CHICKEN RANCH/ DOG KENNEL ❑ WASTEWATER TREATMENT PLANT X HAZARDOUS WASTE/HAZARDOUS MATERIALS ❑ MOTEL/HOTEL ❑ PUMPER TRUCKIYARDICHEMICAL TOILETS X TIERED PERMITTED FACILITY ❑ POOLISPA ❑ LAND USE APPLICATION SITES ❑ TATTOO/BODY PIERCING ❑ COMPLAINTIRESPONSE RECORDS ❑ OTHER (PLEASE SPECIFY) WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) 1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checking the appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-0138 or mail to the address indicated above. Address ranges will not be accepted - for additional assistance with file addresses, contact the EHD. Applications received after 3:00 pm will be processed the next business day. 2. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten (10) days after receipt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may be submitted when the file is available. 4. Any file not returned in the same condition as released will be reorganized by END staff at the expense off the applicant. Future file reviews by the same applicant may require a $125 deposit prior to review. ***BOXED AREA ,EHD USE ONLY AM 100 100",