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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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PR0545308
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
2/10/2020 6:53:34 PM
Creation date
2/10/2020 4:59:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545308
PE
2959
FACILITY_ID
FA0000932
FACILITY_NAME
DOMINO'S #8588
STREET_NUMBER
305
Direction
S
STREET_NAME
HUTCHINS
STREET_TYPE
ST
City
LODI
Zip
95240
APN
03319020
CURRENT_STATUS
02
SITE_LOCATION
305 S HUTCHINS ST
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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1112612012 10:52 Advanced GeoEVmental Inc. 4)209 467 1118 P.0011001 <br /> DATE RECEIVED EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> RECEIVE® ENVIRONMENTAL HEALTH DEPARTMENT <br /> T 1868 East Hazelton AvenUe, Stockton, CA 95205-6232 <br /> NOV 26 2OT?Iophone: (209) 468-3420 Fax: (209) 484-0138 Web: www.sjgov.org/ehd n <br /> ENVIRONMENTAL HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> 000nnlT/erW,,ER <br /> APPLICANT: Rebecca Natal BUSINESSIAGENCY: Advanced Geo Environmental <br /> ADDRESS: 837 Shaw Road CITYISTATEIZIP: Stockton / CA/ 95215 <br /> PHONE(1): 209-467-1008 PHONE(2): 209-623-7200 FACSIMILE: 209-467-1118 <br /> TENTATIVE"APPOINTMENT DATE: gSAP Time: <br /> (Please allow 10 business days from date of appttcatlon submittal-'Tentative only.must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$125 F 0 C K ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT .. DATE_/[ �(e•-1n <br /> Electronlo Information: 0 List❑ Map—Deserlptlon: <br /> FILE ADDRESS EHD USE ONLY <br /> Stre6tR Street Name City r Unit1 <br /> 1• 604 West Lodi Avenue Lodi <br /> 2. 508 West Lodi Avenue Lodi A unit 2 <br /> 3, 305 South Hutchins Street ?SL's 2°�� Lodi <br /> 4. <br /> F7 unit 3 <br /> S. I.. <br /> 7"qz- AUnit" <br /> / <br /> 7. �z <br /> 8. < <br /> Unit 6 <br /> 9. <br /> 10. <br /> v Unit 9 <br /> Specific Date Range of Information Requested: Fromall to ` <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUPSITE(LOP) ❑HOUSING ABATEMENT [jX, SOLID WASTE FACILITYNEHICLE <br /> ❑X OTHER CLEANUP SITE(NON-LOP) ❑Foon FACILITY 0 WASTE TIRE <br /> X❑UNDERGROUND YANK(MONITORINGIREMOVAL) ❑DOG KENNEL 0 DAIRY <br /> ❑x HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> Q TIERED PERMITTED FACILITY ❑MOTELIHOTEL [❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATTOOIB013Y PIERCING ❑POOVSPA Q LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY Q COMPLAINT RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVI6w: MONDAY-FRIDAY 8:00 AM-B:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses In the apace above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At feast one file type MUST be selected. Fax to(209)464-0138 or mail to the address indlcated 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 files exist. An appointment for review will be confirmed approxlmalely tan(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 /> 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 applicant. <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. <br /> EMD USE ONLY <br /> ENO 4848 <br /> Willi <br /> Received Time Nov, 26. 2012 10:49AM 16, 1689 <br />
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