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�`� <br /> ��111 E � SAN .10AQUIN COUNTY EHD LOG NUMBER <br /> JUL 3 1 2017 $1\ ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> 3fve <br /> ENVIRQNx61Fl=NTALI�I=ALTTFf Telephone: (209)468-342Q Fax: (2(}9)464-0138 Web:www.sjgov.org/ehd <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: TAMMY WOODS BUSINESSIAGENCY: TERRACON <br /> ADDRESS: 902 INDUSTRIAL WAY CITYISTATEIZIP: LODI, CA 95240 <br /> PHONE(1): 209-367-3701 PHONE(2): FAX OR E-MAIL: tkwoods@terracon.co <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 /> El CHECK BOX TO EXPEDITE REQUEST-$130 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ///'� ) a DATE 7-31-17 <br /> _ <br /> 1. List u to ten addresses in the space below. Select the type(s)of files from the list below 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. <br /> Electronic Information: ❑ List❑ Map—Description: <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS ttm <br /> SE ONLY <br /> FILES <br /> ®UNDERGROUND TANK(UST) Street# Street Name City <br /> CLEANUPSITE(LOP) j 3515 Navy Drive StocktoTFA <br /> pT CoN M <br /> OTHER CLEANUP SITE(NON-LOP 7f, <br /> N HAZARDOUS WASTE ❑DAIRY <br /> TIERED PERMITTED FACILITY 2 <br /> ®ABOVEGROUND TANK PWS <br /> UST(MONITORING f REMOVAL) <br /> 3 <br /> HAZARDOUS MATERIALS <br /> N SPILURELEASE RESPONSE M'WATLR QUALITY <br /> Q SOLID WASTE FACILITY I VEHICLE 4 <br /> FOOD FACILITY <br /> POOL I SPA d 51T MITIGATION <br /> DAIRY it l <br /> ❑,LAND USE APPLICATION SITES ❑HOUSING <br /> SEPTIC PUMPER TRUCK S <br /> YARD I CHEMICAL TOILETS <br /> CUPA <br /> F7 WASTEWATER TREATMENT PLANT ; <br /> ❑HOUSING ABATEMENT 7 <br /> ❑MOTELIHOTEL CUPA-HAZ-MAT <br /> ®CHICKEN RANCH I DOG KENNEL E <br /> ❑MEDICAL WASTE FACILITY <br /> TATTCCIBOOY PIERCING ❑SOLID WASTE <br /> WASTE TIRE 9 <br /> ®COMPLAINT LM ACCOUNTING <br /> N OTHER{PLEASE SPECIFY): <br /> 10 <br /> WELL&SEPTIC PERMITS rOR#S 1 <br /> Specific Date Range of Information Requested: From to <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS <br /> p —BOXED A`REA-EHD USE ONLY* <br /> ACL'atti'S IM 1 L <br /> 0 Records prove ed by Staff-PPR Complete. staff Name: <br />