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' CEIVED <br /> DATE RECEIVED SAN JOAQUIN COUNTY EHO LOG NUMBER <br /> FEB 0 F: 2017 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 yt �/✓/'� <br /> L'WROINIAWALIHMTH Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd VV <br /> PEIWIT/SERWMS PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: TAMMY WOODS BUSINESS/AGENCY: TERRACON <br /> ADDRESS: 902 INDUSTRIAL WAY CITYISTATEIZIP: LODI, CA 95240 <br /> PHONE(1): 209-367-3701 PHONE(2): FAX OR E-MAIL: tkwoodso_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 /> ❑ CHECK BOX TO EXPEDITE REQUEST-$130 FEE(CASH OR CHEC ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT 4��/A DATE 2-7-17 <br /> 1. List up to ten addresses in the space below. Select the type(s)of files from the list below 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. <br /> Electronic Information: ❑ List❑ Map—Description: <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT FILE ADDRESSFILES EHD USE ONLY <br /> ®UNDERGROUND TANK(UST) Street# Street Name city I(�1 <br /> CLEANUP SITE(LOP) �r7 <br /> ®OTHER CLEANUP SITE(NOR-LOP t 1648 N.Shaw Road Stockton M�� i 1 p CONSUMER <br /> HAZARDODS WASTE 0� [3 DAIRY <br /> ®TIERED PERMITTED FACILITY 2 Y L..X5' 7 <br /> ABOVEGROUND TANK IS <br /> ®UST (MONITORING I REMOVAL) ❑PWS <br /> ®HAZARDOUS MATERIALS a <br /> ZSPiuE RELEASE RESPONSE <br /> ®SOLID WASTE FACILITY I VEHICLE 4 WATER QUALITY <br /> ❑FOOD FACILITY <br /> ❑POOL I SPA <br /> ❑DAIRY 6 SITE MDIGATION <br /> ❑LAND USE APPLICATION SITES <br /> ❑SEPTIC PUMPER TRUCK ❑HOUSING <br /> 6 <br /> YARD 1 CHEMICAL TOILETS <br /> ❑WASTEWATER TREATMENT PLANT COPA <br /> ❑HOUSING ABATEMENT r <br /> ❑MOTEIIHOTEL <br /> ❑CHICKEN RANCH IDOG ItENNBa iACUPA- Cj T <br /> ❑MEDICAL WASTE FACILITY UU�5�1 <br /> ❑TATTOOIBODY PIERCING <br /> ®WASTE TIRE y SOLID WASTE <br /> ®COMPLAINT <br /> ®OTHER(PLEASE SPECIFY): /t ❑ACCOUNTING <br /> WELL AND SEPTIC PERMITS TO <br /> F);1 ADDRESS ONLY <br /> Specific Date Range of Information Requested: From to <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY•FRIDAY 8:0o AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> —'BOXED AREA-EHD USE ONLY*** <br /> (i <br /> Q`Records rovi d by Staff-PPR Corn plete. Staff Name: <br />