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r <br /> RWEIVED SAN JOAQUIN COUNTY FILE CONTBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT ^1k(0 1 <br /> SEP 2Q15 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES 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 TKWOODS@TERRACON.COM DATE 09-11-15 <br /> Electronic Information: ❑ List ❑ Map- Description: <br /> FILE ADDRESS <br /> Street# Street Name City <br /> EHD LISP nNLY <br /> 1. 4932 Pacific Avenue 0STOCKTON <br /> 5151 I Pacific Avenue STOCKTO ❑ Unit 1 <br /> 5110 Pacific Avenue STOCKTON � 0%itz li <br /> 4. �;i <br /> ❑Unit 2H <br /> 5. <br /> 6. <br /> Unit 3 <br /> 7. E / <br /> Unit 4 <br /> EY/8. <br /> SITE A ION <br /> 9. <br /> lx� <br /> 10. ��` � to v Unit 5 <br /> Specific Date Range of Information Requested: From _ALL to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES Ar <br /> RI UNDERGROUND TANK(UST)CLEANUP SITE(LOP) [:]MEDICAL WASTE FACILITY IX SOLID WASTE FACILITY/VEHICLE/V f <br /> X OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT LX WASTE TIRE <br /> 13�UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> IX ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL WASTEWATER TREATMENT PLANT <br /> HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTEL/HOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> )f TIERED PERMITTED FACILITY ❑POOL/SPA LAND USE APPLICATION SITES <br /> U TATTOOIBODY PIERCING COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(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$130 deposit prior to review. ***BOXED AREA-EHD USE ONLY*** <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> EHD 48.06 <br /> 711/15 <br />