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� 6 PM —0500 Terracon Fax Server PAGE 2 OF 2 <br /> DATE !FCE1VE!VE <br /> APR � u• ZOr� N,2 SAN .IOAQUIN COUNTY EHD LOG NUMBER <br /> �[A(/iJ 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT ^�� <br /> ✓v v 1 <br /> 1East Hazelton Avenue, Stockton, CA 95205-6232 <br /> PE�(IT/SEfFAZE 4SlTAL I-F_�TH Telephone:: (2(209)468-3420 Fax: (209) 464-0138 Web:www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Sadie Bodiford BUSINESS/AGENCY: Terracon <br /> ADDRESS: 50 Goldenland Court, Suite 100 CITY/STATE/ZIP: Sacramento, CA 95834 <br /> PHONE(1): 916-246-5080 PHONE(2): FAX ORE-MAIL: sadie.bodiford@terracon.com <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-$139 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT Sadie Bodiford (electronic signature) DATE 4-28-17 <br /> 1. List up 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 notifythe 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$139 deposit prior to review. 5/� <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> Electronic information: ❑ List ❑ Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESS EHD USE ONLY <br /> X UNDERGROUNDTANK(UST) Street# Street Name City <br /> CLEANUP SITE(LOP) caxsuxeM1 <br /> ❑OTHER CLEANUP SITE(NON-LOP) ' 321 Spreckles Avenue AAvem4a_ <br /> IX HALIROOUSWA6TE � . TI'L'4t"!f rt71 <br /> DgIM1Y <br /> IX TERM ABOVE ROUND PERMITTED FACILITY 2 APN: 221-210-200 <br /> [XABOVEGROUNDABOVEGROUND TANK <br /> FX UST (MONITORING/REMOVAL) RN6 <br /> X I HAZARDOUS MATERMS 3 <br /> ❑SPILLRRELEASE RESPONSE <br /> ❑SOLID WASTE FACILITY/VEHICLE WgrzM1 ODa.m <br /> d <br /> FOOD FACILITY <br /> I]POOL/SPA <br /> �Slrz Mmognox <br /> ❑DAIRY S I <br /> D( LAND USE APPLICATION SITESS—N—i <br /> ❑SEPTIC PUMPER TRUCK/ 11H...IN. <br /> 8 <br /> YARD/CHEMICAL TOILETS <br /> ❑WASTENATER TREATMENT P IANT <br /> HOUSING ABATEMENT T CUPA <br /> ❑MOTS-MOTEL <br /> F-1 CHICKEN RANCH/Doe KENNEL <br /> CUPA UST <br /> ❑MEDICAL WASTE FACILITY 6 <br /> TATTOO/BODY PIERCING <br /> ❑WASTE TIRE []S.U.W..T. <br /> ❑COMPLAINT a <br /> ❑OTNER(PLEASE SPECIFY): <br /> TO ACCOVImN6 <br /> ""BOXED AREA•EHD USE ONLY"• <br /> O Records provided by Staff-PPR Complete. Staff Name: <br /> Received Time=Apr. 28. =2017=10:39ANFNo. 1346 <br />