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04/06/2015 2 :46: 23 PM -0506 <br /> 050 Terracon Fax Server PAGE 2 OF 2 <br /> SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> �111 �� ENVIRONMENTAL HEALTH DEPARTMENT <br /> A Pi? 0 6 2015 1868 East Hazelton Avenue, Stockton, CA 95205-6232 (n/ <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sjgov.org/ehd x <br /> ENVIRONMENTALPERM (SERV/ EALTH PUBLIC RECORDS RELEASE APPLICATIONy <br /> PERAAIT/SERVICES <br /> APPLICANT: Sadie Bodiford BUSINESS/AGENCY: Terracon <br /> ADDRESS: 50 Goldenland Court, ; 100 CITY/STATEIZIP:Sacramento, CA 95834 <br /> PHONE(1): 916-246-5080 PHONE(2): 831-332-3736 FACSIMILE: 916-928-4697 <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-$130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT SadieBodiford DATE 4/6/15 <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑Unit1 <br /> 1. 3735 Imperial Way Stockton (NnP �Jh V <br /> 2. <br /> ❑Unit 2 <br /> 3. <br /> 4' ailnit.3 <br /> 5. <br /> S. tWv"IeK 3ttl Unit4 <br /> 7. <br /> 8. -r'J-1� ❑Unit 5 <br /> 9. <br /> 10. <br /> ❑unit s <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> X❑UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACILITYIVEHICLE <br /> ❑OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE <br /> ®UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> IT ABOVEGROUND TANK ❑CHICKEN RANCH/Doe KENNEL ❑WASTEWATER TREATMENT PLANT <br /> ®HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑,TATTOO/BODY PIERCING ❑COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <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 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 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$130 deposit prior to review. ***BOXED AREA-EHD USE ONLY*** <br /> 4-1'�' IS — ke.-to I' - y 1{ Aeel 46e 04re I& Iwim of- <br /> 40- <br /> haMk 5106 ciA& LZR Pe -Wi .ml COW'55'67'X ,z Wk f Ie Z s = X41k VA <br /> 11 Records provided by Staff-PPR Complete.Staff Name: <br /> Received Time Apr. 6. 2015 12:46PM No. 8466 0e10fn4 <br />