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RECEIVED <br /> DATE RECEIVED SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> FE8 14 2017 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> 2Ii/1RONhIENTAL Wmlflelephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.orglehd 815&05 <br /> PErWIT/SER,rMA PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: TAMMY WOODS BUSINESSIAGENCY: TERRACON <br /> ADDRESS: 902 INDUSTRIAL WAY CITYISTATEJZIP: LODI, CA 95240 <br /> PHONE(1): 209-367-3701 PHONE(2): FAX OR E-MAIL: tkwoods@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 CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANTj �crlL DATE 2-13-17 <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 ADDRESS <br /> FILES EHD USE ONLY <br /> ®UNDERGROUND TANK(UST) Street# Street Name city <br /> CLEANUP SITE(LOP) <br /> ®OTHER CLEANUP SITE(NON-LOP) 1 1700 N. Broadway Stockton ftl` r) ; �i [ICONSIIMEIT 2 2 a <br /> ❑HAZARDOUS WASTEV DAIRY <br /> ❑TIERED PERMITTED FACILITY z 1448 t Shaw Road Stockton (�I 3ry DAIR <br /> ®ABOVEGROUND TANK FC <br /> ®UST (MONITORING I REMO f n1 El PWS <br /> ❑HAZARDOUS MATERIALS 3 1282 Shaw Road Stockton I•� (-j' (Yr <br /> ®SPILLIRELEASE RESPONSE <br /> E0 WATER QUALITY <br /> ❑SOLID WASTE FACILITY I VEHICLE 4 <br /> ❑FOOD FACILITY <br /> ❑POOL I SPA <br /> ❑DAIRY 51 SITE MITIGATION <br /> ❑LAND USE APPLICATION SITES A-rn Ah 11 P <br /> f-; "• ` <br /> F]SEPTIC PUMPER TRUCK I e i5p 1 ts ❑Hausm <br /> YARD I CHEMICAL TOILETS e " I <br /> A <br /> ❑WASTEWATER TREATMENT PLANT ( ±e -(L, I LAO <br /> CUPA <br /> ❑HOUSING ABATEMENT 7 <br /> ❑MOTELIHOTEL <br /> ❑CHICKEN RANCH I DOG KENNEL CUPA <br /> ❑MEDICAL WASTE FACILITY e <br /> ❑TATTOOIBODY PIERCING ❑SOLID WASTE <br /> ❑WASTE TIRE y <br /> ®COMPLAINT <br /> ❑OTHER(PLEASE SPECIFY): <br /> ❑ACCOUNTING <br /> 10 <br /> Specific Date Range of Information Requested: From to <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> ***BOXED AREA-EHD USE ONLY*** 1 <br /> 1Lei A x <br /> Records provided by Staff-PPR Complete. Staff Name: <br />