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V-D, , <br /> R �VECI .. SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> APR 0 5 20j� 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> [�fdfrEraTA�,taF.ARTEFi, <br /> PTv w PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Tammy Woods BUSINESS/AGENCY: NOA/Terracon <br /> ADDRESS: 902 Industrial Way CITY/STATE/ZIP: Lodi, CA 95240 <br /> PHONE (1): 209-367-3701 PHONE (2): FACSIMILE:-209-333-8303 <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 Tammy Woods (tkwoods@terracon.COm) DATE 04/05//2016 <br /> Electronic Information: ❑ List❑ Map—Description: I <br /> s <br /> FILE ADDRESS EHD USE ONLY <br /> Street 0 Street Name City El Unit 1 <br /> 1. 1400 E. Victor Road LODI 1, <br /> 2. 1333 E. Turner Road LODI t/lt7 P units <br /> 3. <br /> 4. ' <br /> 0 Unit 3 <br /> 5. <br /> SITE MITIGATION <br /> 6. <br /> ❑Unit 4 <br /> 7. <br /> 8. <br /> ❑units <br /> 9. <br /> 10. <br /> ❑ Unit <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> A UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY ❑SOLID WASTE FACIL�IEHICLE <br /> El OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ❑WASTE TIRE '3' RS w <br /> ®UNDERGROUND TANK(MONrrORINGIREMOVAL6 ❑FOOD FACILITY ❑DAIRY I.(/I 1 4 . ( L//�'! fO <br /> H ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> ❑HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARD/CHEMICAL TOILETS <br /> ❑TIERED PERMITTED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING ❑COMPLAINT/RESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(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 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 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$125 deposit prior to review. ***BOXED AREA-EHD USE ONLY*** <br /> ea <br /> Mat wa'sr <br /> 5- , YrF o4I 1 s / AO Vi <br /> OI i%-:, ' lt0,.' <br /> d Drovi led by Staff PPR Qe _ <br /> EHD 48-06 5/11H5 <br />