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08/20/2014 16:37 209333830? LODI DOWNSTAIRS - PAGE 02/02 <br /> DATE RECEIVED *010- EHD LOG NUMBER <br /> OUNTY <br /> RECEIE® ENVIRONMENTAL HEALSAN JOAQUINTH DEPARTMENT <br /> AUG 2 2 2014 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: vwvw.sjgov.org/ehd <br /> ENVIRONMENTAL HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> f4FPVl( S <br /> APPLICANT: Heather Shaddox BUSINESS/AGENCY: Neil O. Anderson &Associates <br /> ADDRESS: 902 Industrial Way CITY/STATEIZIP: Lodi,CA 95240 <br /> PHONE (1): 209-367-3701 PHONE(2):209-747-1000 FACSIMILE:209-333-8303 <br /> TENTATIVE`APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal:`Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-31125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE August 21, 2014 <br /> Electronic Information: ❑ List ❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City EdUnIt1 <br /> 1. 200 N.Beckman Road Lodi ILO <br /> 2. 880 E. Victor Road Lodi L1Cttey unit2 <br /> 3. 845 E. Pine Street Lodi - <br /> 4. 900 gd7 th E.Victor Road , - Lodi b/}5� L> <br /> 5. 920 E.Victor Road Lodi C <br /> S. 873 E. Pine Street Lodi /=� � unle a <br /> 7. 861 E. PineStreet Lodi <br /> ... ...... --- <br /> 8. 921 E. Pine Street Lodi _ ❑Unita <br /> 9. 930 E.Victor Road Lodi <br /> 10. 940 E.Victor Road Lodi i Unit 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE.FACILITY OSOUD WASTE FACILITYNEHICLE <br /> ®OTHER CLEANUP SITE(Nom-LOP) ❑HOUSING A13ATEMFNT ®WASTE TIRE <br /> 19 UNDERGROUND TANK(MONrrORNG/RFMOvAL) ❑FOOD FACILITY ® DAIRY <br /> ®ABOVEGROUND TANK ❑CHICKEN RANCHI DOG KENNEL ®WASTEWATER TREATMENT PLANT <br /> ®HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ®PUMPER TRUCKIYARD/CHEMICAL TOILETS <br /> ® TIERED PERMITTED FACILITY ❑POOLISPA ®LAND USE APPLICATION SITES <br /> ❑TATroo/BODY PIERCING ®COMPIANTIRESPONSE 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 mall to the address indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses, contact the EHD. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant if any EHD flies 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 rive business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be Immediately available for review. A new application may be <br /> submitted when the file Is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the ap licant <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. <br /> tt�`+ .jA�Y�j`,- v .T+� r h.TM lF s. .i�, F e '�• =�S ��x�� 'u"i�s. I�i4 t 4R4 I�..� °1L <br /> +„;,w N1111 MUM <br /> M,„n.., 3i t ,r i. lye '. ,q�` .f°Nsy.�„ E�i,;:9' �rk�;yA1;�` Cn Cti jl. h�y' iI•- y'H� '.lf ro iE' ..`i+,' <br /> , ` A w+L�at1 <br /> Received Time:; ug .21 20 41 6:33P N o 890 �� y ' c <br /> .—.en acre:x�gxma.scsch]Yu 'u ri]aG'!y:`.f:'r:SiC"I'4'&??folL3t.0 nkcvT"x-.31SY, ..v'r �F, ��.. °,"r <br />