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RECEIV�SAN ;.�QQQUI (� viIronmental Health Department <br /> COUNTY JAN PUBIC RECORDS RELEASE APPLICATION <br /> MNIWALW 1 �� <br /> EHD LOG NUMBER: <br /> ------------------------ <br /> APPLICANT: Sadie Bodiford BUSINESSIAGENCY: Terracon Consultants, Inc. <br /> ADDRESS: 50 Goidenland Court, Suite 100 _ CITYISTATEiZIP:_Sacramento, CA 95834 <br /> PHONE (1): 916-246-5080 PHONE(2): FAX OR E-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 /> SIGNATURE OF APPLICANT Sadie Bodiford (electronic signature) DATE 1-29-2018 _ <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 /> address indicated below, or email to info(a)sjcehd.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 to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT (Specific Y 9 accepted) EHD USE ONLY <br /> FILES S ecific addresses only,address ranges will not be ecce ted <br /> X Underground Tank(UST) Street# Street Name City <br /> Cleanup&to(LOP) AL i E]CONSUMER <br /> X Other Cleanup Site(Non-LOP 17100 South Harlan Road Lathrop 'AL, <br /> IX Hazardous waste C & + . n 1 ❑DAIRY <br /> Tiered Permitted Facility z I + 6 "� ✓ lJo <br /> IX Aboveground Tank 3 <br /> [X—UST (Monitorirg)Removal) l�f/Gt ❑pis <br /> 3 R 1 vL I <br /> IX Hazardous Materials <br /> le <br /> IX_Spill 1 Release Response t <br /> _ ATER 4l1ALITY <br /> El Solid waste Facility lVehicle 4 PLEASE CONFIRM RECEIPT OF REQUEST BY EMAIL TO: <br /> Food Facility SADIE.BODIFORD@TERRACON.COM <br /> F7 Pool 1 Spa ITE MmcaTroH <br /> Dairy $ <br /> [] Land Use Application Sites /// r,��� — ry <br /> • " ( d f V .�'T HouslNe <br /> X Septic Pumper Truck! 6 <br /> Yard 1 Chemical Toilets A'j ­7 0 <br /> IX wastewater Treatment Plant t P��F z CUPA <br /> ❑Housing Abatement 7 a #` l 7 AST)HM 1 HW <br /> I]MatellHotel �I <br /> Chicken Ranch 1 nog KennelJ t [ (*� UPA <br /> 8 1 t `+� UST <br /> [X Medical waste Facility <br /> Tattoo/Body PiercingE..r!�u <br /> nowAsr <br /> ®waste Tire 9 `."'t �• 1 ,�j Q 71 <br /> Complaint + C <br /> Other(Please Specify): ! ❑ACCOUNTING <br /> 10 <br /> **•BOXED AREA-EHD USE ONLY— I <br /> • 1 -37J'1(-'', ^�.�l�i �' :"rr„ZJ. .^`t.�<a. �{ Irt�G�! �r�4, .,ti. �.�Ov.:,, i,,. r, tn.�� 4� [i�''�.��- r� <br /> ic;li 62 - <br /> d Records p ided by Staff-PPR omplete. Staff Name: EHD 4E-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />