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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0503634
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
5/7/2019 4:40:56 PM
Creation date
5/7/2019 4:15:53 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0503634
PE
2950
FACILITY_ID
FA0005914
FACILITY_NAME
VICTOR ROAD SHELL
STREET_NUMBER
880
STREET_NAME
VICTOR
STREET_TYPE
RD
City
LODI
Zip
95240
APN
04905032
CURRENT_STATUS
02
SITE_LOCATION
880 VICTOR RD
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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FROM : NOA Environmental PHONE NO. 209 369 4228 <br /> "IaR HVtU Dec. 23 2002 12:24PM P3 <br /> SAN .rzrARUIN COUNTYPUBLIC HEALTH $cRVICES EHDiocWMER <br /> ENVIRONMENTAL HEALTH DIVISION <br /> v 304 EAST WEBER AVENUE,THIRD FLOOR <br /> DEC 2 J 2no2 STOCKTON CA 95202 I NIT <br /> (209)468-3420 <br /> 'o"J° �; PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT BUSINESS/AGENCY LJQA <br /> ADDRESS`ZZ �_ �wS�i,N /'"j.j Z t/G <br /> PHONE &00xo7-3`70 / FACSIMILE (Zo9 -To - IZ2-ff <br /> TENTATIVE'APPOINTMENT DATE b 2483 TIME /'D��..�.._ 3 7��.n <br /> � <br /> (Please glue T fo 10 business days from date of application submina]) \ <br /> CHECK BOX TO EXPEDITE REQUEST-SBF);E-RE 7 P OCESSED IN 3 BUSINESS DAYS Un j <br /> SIGNATURE OF APPLICANT DATE <br /> FILE ADpRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> I 880 k r kci, G.cd: G/4 � / r <br /> Z 9D0 yer <br /> 3 vi <br /> s <br /> �tf, <br /> r <br /> 5 L CA <br /> n e, / , ^ a. U' .. <br /> r•.ere des � .. - <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> ril UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> R'OTHER CLEANUP SITE(NON-Lop) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> R' UNDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> W HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTEUHOTEL ❑ PUMPER TRUCKJYARD/CHEM TOILETS <br /> ❑ TATTOO/SODY PEIRCING 0 POOLISPA ❑ LAND USE APPLICATION SITES ' <br /> Cl MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ¢i OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to (209)464-0138 or mail to the <br /> address indicated above. <br /> 2. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten (10) days after receipt of application. The files <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A flle that is actively being worked on by EHD staff may not be immediately available for review. A new <br /> application may be 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 <br /> of the applicant. Future file reviews by the same applicant may require a $89.00 deposit prior to review. <br /> 5. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> 11+,IdM. <br />
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