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RECEIVED <br /> S A N J O A Q U 1 NFA `s � Environmental Health Department <br /> -- C O U N T r- �— PUBLIC RECORDS RELEASE APPLICATION <br /> PEi4 IIT�SEM%A Y EMAIL <br /> EHD LOG NUMBER. jq <br /> 44 <br /> APPLICANT: Tonya Scheftner BUSINESS/AGENCY: Petralogix Engineering,Inc. <br /> ADDRESS: 26675 Bruella Road CITY/STATE/ZIP: Galt,CA 95632 <br /> PHONE(1): 209.770.0731 PHONE(2): FAX OR E-MAIL: tscheftner@petralogix.com <br /> Please allow ll 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 /> SIGNATURE OF APPLICANT E_An7 �r DATE June 21,2018 <br /> 1. List up to ten addresses in the space l5elow. Address 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)464-0138, mail to the <br /> address indicated below,or email to info(cDsicehd 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 END at the number noted below. <br /> 3. The EHD will notify the applicant if any END 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 <br /> HEALTH DEPARTMENT FILE ADDRESS A-co Z <br /> FILES (Specific addresses only,address ranges will not be accepted) EHD USE O N L <br /> Underground Tank(USr) Street# Street Name city <br /> Cleanup Site(LOP) i-tl , ®'CONSUMER <br /> Other Cleanup Site(Non-LOP) <br /> 1 3 S Pacific Avenue Lodi y� <br /> lXJ Hazardous Waste <br /> 101 S Ham Lane Lodi " `' 11 DAIRY <br /> Q Tiered Permitted Facility 2 <br /> Aboveground Tank <br /> ®UST (Monitoring/Removal) ❑PWS <br /> ©Hazardous Materials 3 1320 W Elm Street Lodi <br /> Q Spill/Release Response <br /> Solid Waste Facility/Vehicle 4 1320 W Lr1, 1 WA <br /> `t ®' TER QUALITY <br /> oekeford Street <br /> ®Food Facility Lod i <br /> Pool/S a RE MRIG TIOn <br /> Dairy p S 1341 W Lodi Avenue Lodi <br /> F]Land Use Application Sites <br /> F1 Septic Pumper Truck/ 6 1540 W Lodi Avenue Lodi ❑HOUSING <br /> Yard/Chemical Toilets <br /> ❑Wastewater Treatment PlantkA- <br /> ®t 11PA <br /> ❑Housing Abatement 7 301 S Ham Lane Lodi AST/HM/HW <br /> F]Motel/Hotel _ <br /> Chicken Ranch/Dog Kennel {^Q (� i4o.CUPA <br /> Medical Waste Facility <br /> 1800 W Elm Street Lodi UST <br /> F]Tattoo/Body Piercing nnnl, Gt _ f!� <br /> I]waste Tire B <br /> ❑SOLID WASTE <br /> Q Complaint PROS7(35_74— �� ? <br /> F1 Other(Please Specify): PRO�i�{t�✓�l'1–(tM,��/ El ACCOUNTING <br /> 10 <br /> —BOXED AREA-EHD USE ONLY— <br /> ro 05135�J' <br /> Y1111rij 4-0c) F)22 12d <br /> ❑ Records provided by Staff-PPR Complete. staff Name: eHo as <br /> 1868 E. Hazelton Avenue I Stockton,California 95205 1 T 209468-34201 F 209464-0138 1 www.sjcehd.com <br />