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DATE RECEIVED 0 EHD LOG NUMBER <br /> �' SAN .�aAQUIN COUNTY <br /> �"" ENVIRONMENTAL HEALTH DEPARTMENT � ,� � G <br /> ,., . R a 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �� l t 9 Telephone: (209)468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> ,VIRONMENTA Hl" rH PUBLIC RECORDS RELEASE APPLICATION <br /> PERMITISEROCES <br /> APPLICANT: Abby Racco BUSINESS/AGENCY: Live Oak GeoEnvirnilmental <br /> ADDRESS: 407 W. Oak St. CITYISTATE/ZIP: Lodi CA 95240 <br /> PHONE (1): 309-0375 PHONE (2): 365-3222 FACSIMILE: <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 Abby Racco DATE 3-4-16 <br /> electronic Information: ❑ List ❑ Map--Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City <br /> 1. 21025 S. Carrolton Rd. afl 1 <br /> 2. 20991 S. Carrolton Rd. Ripon /U0 ❑ unit <br /> 2 . 21399 S. Carrolton Rd. Ripon A}a �qUA;1 unit2 <br /> 1� 4. 18832 E. Mello Ripon CVF No Wj7 ❑Unit 2H <br /> -.J 5. 19102 E. Mello Ripon A9-T, -j .f") C,I,fix U4*0031o) <br /> 6• 303 S. Reid Ave. E`unit3 <br /> ( 7. 0 Reid Ave. (FA0018566, 800601869) j n bo ❑ Unit 4 <br /> 8. SITE MITIC-ATION <br /> 9. <br /> 10. k Unit] <br /> Specific Date Range of Information Requested: From all availablQ to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES 4- <br /> UNDERGROUND TANK(LIST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACIL YNEMCL r <br /> OTHER CLEANUP SITE(NON-LOP) ❑HOUSING A6ATEMENT ❑WASTE TIRE ,, T` <br /> [ UNDERGROUND TANK(MONITORINGIREMOVAL)`� ❑FOOD FACILITY [I DAIRY V n . <br /> ®ABOVEGROUND TANK dl. []CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> ®HAZARDOUS WASTEIHAZARDOUS MATERIALSOk ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICALToILETS <br /> ®TIERED PERMITTED FACILITY ❑POOL/SPA ®LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING R]COMPLAINTIRESPONSE RECORDS ®OTHER(PLEASE SPECIFY) SSCR for 303 S.Reid <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILASLE 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 all 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 /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> 7!1115 <br /> eHD 4a-06 <br />