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SAN JO.A,QUIN COUNTY EHD LOG NUMBER <br /> W- 4— <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> lu W <br /> 600 E. MaiD Street, Stockton, CA 95202-3029 009 II leplione: (209)468-3420 Fax: (209)464-0138 Web: cvww.sjg0v,0I,g/ehdqyS <br /> i' <br /> L`.a�$H PUBLIC UCORDS RELEASE APPLICATION <br /> ti ^ <br /> APPLICANT:Ab y aCCO BUSINESS/AGENCY: Live Oak GeoEnvironmenta <br /> ADDRESS: 447 W. Oak St., Lodi, CA 95240 <br /> PHONE(1): (209) 369-0375 PHONE(2): 209 <br /> FACSIMILE:( ) $69-0375 <br /> TENTATIVE*APPOINTMENT DATE, December 8, 2009 Time:9:00 am <br /> (Please allow 10 business days from data of application submittal-*Tentatrye only-must be confirmed) <br /> 0 CHECK BOX TO EXPEDITE REQU T-$915.0 EE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE l (`2-3—C7`t <br /> Electronic Information: ❑List[j Map-Description; <br /> W FILE ADDRESS EHD USE ONLY <br /> street# street Nance City <br /> �. 27 S, Banta Rd. <br /> 337 Unit 1 <br /> Tracy Ain et) <br /> 2. <br /> ❑ Unit 2 <br /> 3. <br /> 4, r% nit 3 1 <br /> s. W - Unit d , <br /> 7. <br /> 8 ❑ Unit 5 <br /> 10 ❑ Unit 6 <br /> Specific Date Range of Information Requested:From all available to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDUMPOVND TANK(UST)CLEANUP SITE(LOP) Q HOUSING ABATEMENT 11 SOLID WASTE FACILITYIVEHICLE ah <br /> OTHER CLEANUP SITE(NON-LOP) ©Fow FACILITY 13 WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVALa E3 DOG KENNEL a DAIRY <br /> HAZAR00135 WASTE GENERATOR 04.- 0 CNICKtN RANCH 13 WA&YFWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY DC ❑MOTEL/HOTEL 0 PUMPER TRUCK/YARDICHEM TOILET$ <br /> TATTOO/BODY PIL*RCINQ 13 PoOL/SPA 13 LAND USE APPLICATION$ITE$ <br /> Q MEDICAL WASTE FACILITY 13 OTHER(PLF_ASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 5:00 AM-6,00PM - EXCLUDING HOUDAYS. <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 p�rtaa11 to the address indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD.Applications received atter <br /> 3:00 pm will be processed the next business day. <br /> 2. 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 /> 3, A file that is actively being worked on by EHD staff may not be immediately available for review. A new application may be <br /> submitted when the file Is available. <br /> 4, Any file not returned in the same condition as released will be reorganized by END staff at the expense of the applicant <br /> FLIture file reviews by the same applicant may require a$96.00 deposit prior to review. <br /> EHD USE ONLY <br /> EWD"-a 911&2"woo -- <br />