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RECEIVED <br /> ED <br /> SAN,,doAQUI p <br /> �r�>�Y � � ���� Environmental Health Department <br /> COUNTY--- ,�� � PUB IC RECORDS RELEASE APPLICATION <br /> fid'} VoloL <br /> pEll! IT EMAIL y21 <br /> EHD LOG NUMBER: <br /> APPLICANT: TAMARA WOODS EUSINESSIAGENCY:TERRACON <br /> ADDRESS: 902 INDUSTRIAL WAY CITYISTATEIZIP:LODI,CA 95240 <br /> PHONE (1): 209-269-8586 PHONE(2): FAX OR E-MAIL: TKWOODS@aTERRACON.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 /> SIGNATURE OF APPLICANT Woods, Tamara K DATE 5-2-18 <br /> 1. List up to ten addresses in the space below. 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 /> addressindicatedbelow, or email to info(a�sicehd.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 ALL AVAILAELE YEARS to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT ( p y EHD USE NLY <br /> FILES (Specific addresses only,address ranges will not be accepted) <br /> Q Underground Tank(UST) Street# Street Name City �y/ ,!A <br /> Cleanup Site{LDP} 2395 ❑O L LY DRI V T RAC 1 N J t E]C©wsuMea <br /> Q Other Cleanup Site(Non-LOP) 1 <br /> ®.Hazardous Waste 0 .-.-- 4.o Ij DAIRY <br /> )( Tiered Permitted Facility 2 2820 HOLLY DRIV <br /> Q Aboveground Tank 19 <br /> Q UST (Monitoring 1 Removal) El PIN'S <br /> FXJ Hazardous Materials 3 4030 MORADA LAN TOCKTON -� <br /> ❑Si Splll I Release Response WZ <br /> 5o5d waste Facility!Vehicle 49373 N. HIGHWAY 99 ST( KTQ N t4 <br /> LXV <br /> ❑ Food Facility <br /> Poo9 1 Spa * {� , #® 01' SITE MITIGATION <br /> ❑Dairy s 9393 N. HIGHWAY s CTKTON 101a <br /> [E Land Use Application Sites <br /> ❑H6t15fNG <br /> ❑Septic Pumper Truck 1 6 <br /> Yard 1 Chemical Toilets <br /> ❑wastewater Treatment Plant GUPA <br /> R Housing Abatement 7 AST l HM l HW <br /> El MotellHotel <br /> E]Chicken Rench 1 Dog Kennel CUPA <br /> Medical waste Facility ® UST <br /> I]Tattoo/Body Piercing ❑Snlln WASTE <br /> Waste Tire 9 <br /> Q Complaint <br /> Other(Please Specify): ❑ACCOUNTING <br /> 10 <br /> "*BOXED AREA{-EHD USE ONLY" <br /> rr'�n„ 1�+.}J:C_ '�2'� <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: EHD 48-06 <br /> 1868 E. Hazeiton Avenue I Stockton, California 95205 T 209 468-3420 F 209 464-0138 1 www.sjcehd.com <br />