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IVSAN <br /> � ( � � �� Environmental Health Department <br /> -COUNTY---FEB 12 2018 PUBLIC RECORDS RELEASE APPLICATION <br /> ENVIRONMENTAL HEALTH <br /> I�j V`��o S5 <br /> EMD LOG NUMBER:. <br /> APPLICANT: Taml�E „r,r��-�.,...�ara Woods —83 BUSINESS/AGENCY: Terracon <br /> ADDRESS: 902 Industrial Way CITYISTATEIZIP:_Lodi CA 95240 <br /> PHONE(1), _209-269-8586 PHONE(2): FAX OR E-MAIL:tkwoods@terracon.com <br /> Please allow lu business aays from date of application submittal for the records to be available. <br /> Staff will contact you to arranoe an annointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT ; 'I �( DATE-2-12-18 <br /> 1. List up to ten addresses in the spacDelow. ,vaaress 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)46.4-0138, mail to the <br /> address indicated below,or email to infoi_C_<sfcehd.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 1 <br /> HEALTH DEPARTMENT ( p 9 accepted) EHD USE ONLY <br /> FILES (Specific addresses and address ranges will not be aace ted <br /> 'Underground Tank(UST) Street# <br /> Street Name City , <br /> OtheCiear Cl Site{LOP) \ J .4,A 1 <br /> CONSUMEA <br /> Other Cleanup Site(Non LC P) ' 330 Kettleman Lane Lodi ���� �) $ V -� <br /> ZHazardous Waste % [J Rv <br /> ❑Tiered Permitted Facility 2 100 W. Lodi Avenue Lodi a. r �, ) � 1 <br /> 4t <br /> Q Aboveground Tank 5ih t uy u� C�'i <br /> OUST (Monitoring!Removal) C/ <br /> ❑Hazardous Materials s 420 S. Pleasant Avenue Lodi <br /> 0 Spill P Release Response <br /> ,.,1 <br /> 71 Solid Waste Facility I Vehicle 4 820 S. Cluff Avenue Lodi <br /> ❑Food Facility 5i^ Hn,NW v1�i I14 <br /> + , <br /> ❑Pool 1 Spaf} p� SITE MITican0N <br /> ❑Dairy 5 2525 S. HutChins Street Lodi 0-v r3 ( <br /> ❑Land Use Application sites �, Lo"`n ' �9 q <br /> ❑Housmc <br /> �]septic Pumper Truck l 6 902 industrial Way Lodi <br /> Yard/Chemical Toilets ti }y� (,>,�-�� Iri-e� <br /> ❑Wastewater Treatment Plant L -.p 1C_eZ5- CUPA <br /> F1 Housing Abatement 7 420 Kettleman Lane Lodi I-t to 6 P� I N� HW <br /> ❑Motel/Hotel ' I-kW riM i '&I')) <br /> ❑Chicken Ranch 1 Dog Kennel .f � UPA <br /> a 501 Kettleman Lane Lodi r� <br /> Med'aca!Waste Facility l3T <br /> ® P <br /> La Tattoc/Body Piercing L r1/,, (�. 1'"� �n! SDLID WASTE <br /> ❑Waste Tire 9 514 Kettleman Lane Lodi <br /> complaint M I r�`► <br /> ❑ <br /> _Other(Please Specify): ia 1025 Industrial Way�,�_„ ,r Lodi A o is������ <br /> y <br /> ***BOXED AREA+-EHD USE ONLY*** <br /> I cA i ^I}-Il�-�n4YICh (✓ i:�c� ie z i i� f l �n1Jfi �2 C� GIC C✓v� {t l'4. ec <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 />