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RECEIVED I <br /> S A N oJ O A Q U I NEnvironmental Health Department <br /> COU N T`r' - � PUBLf RECORDS RELEASE APPLICATION <br /> /� /� q31 <br /> s t rota 5 +'�- MAIL �� r,JV` <br /> • PEMM EHD LOG NUMBER: <br /> 10 <br /> APPLICANT: TAMARA WOODS BUSINESS/AGENCY:TERRACON CONSULTANTS INC. <br /> ADDRESS: 902 INDUSTRIAL WAY CITY/STATEIZIP:LODI,CA 95240 <br /> PHONE(1): 209-269-8586 PHONE(2): FAX OR E-MAIL: TAMARA.WOODS@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 /> SIGNATURE OF APPLICANT DATE 6-5-18 <br /> 1. List up to ten addresses in the space below. Address ranges WILL NOT be accepted. Select the type(s)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 info(a-)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. <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 ( p y 9 accepted) EHD USE ONLY <br /> FILES (Specific addresses only, address ranges will not be acce ted M <br /> Q Underground Tank(UST) Street# Street Name City `; y <br /> Cleanup Site(LOP) I_l vv( <br /> � ❑CONSUMER <br /> OOther Cleanup Site(Non-LOP) 1 2985 E. Loomis Road Stockton fndi;;L 6,,2k-Km-�� <br /> 0 Hazardous Waste r,NtI-k)A DAIRY <br /> ❑X Tiered Permitted Facility 2 3112 E. Loomis Road Stockton <br /> ❑X Aboveground Tank <br /> ❑X UST (Monitoring I Removal) I w WS <br /> 3 <br /> 0 Hazardous Materials 2929 HWY 99 W FRONTAGE RD Stockton mes i-4- RM ✓ <br /> ❑X Spill I Release Response EKNATER QUALITY <br /> ❑X Solid Waste Facility I Vehicle 4 <br /> Food Facility <br /> ITE MITIGATION <br /> Pool I Spa <br /> 5 <br /> Dairy <br /> ❑Land Use Application Sites <br /> ❑HouswG <br /> ❑Septic Pumper Truck 1 5 <br /> Yard I Chemical Toilets <br /> Wastewater Treatment PlantUPA <br /> AST I HM/HW <br /> Housing Abatement 7 L <br /> Motel/Hotel COPA <br /> Chicken Ranch I Dog Kennel <br /> S UST <br /> ❑Medical Waste Facility <br /> Tattoo/Body Piercing SOLID WASTE <br /> Q Waste Tire 9 <br /> Q Complaint <br /> Other(Please Specify): ❑ACCOUMING <br /> 10 <br /> t) A-***BOXED AREA-EHD USE ONLY*** <br /> re'c '54- <br /> 0 <br /> ❑ Records provided by Staff-PPR Complete. staff Name: EHD 48-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />