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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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3500 - Local Oversight Program
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PR0545307
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
2/11/2020 3:02:32 PM
Creation date
2/11/2020 8:53:24 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545307
PE
3528
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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11/26/2012 10:52 Advanced GeoEn%,-- mental Inc. (FdX)209 4671118 P.0011001 <br /> DATE RECEIVED <br /> SAN JOAQUIN COUNTY EHD LOO NUMBER <br /> j CE1%§;'" ENVIRONMENTAL HEALTH DEPARTMENT r <br /> 1868 East Hazelton Avenue, Stockton CA 95205-6232 <br /> lephone; (209)468-3420 Fax:(209)464-0138 Web:www.s ov.or /ehd � <br /> NOV 2 6 2Q�� 1s g <br /> ENVIRONMENTAL HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Rebecca Natal BUSINESS/AGENCY: Advanced Geo Environmental <br /> ADDRESS: 837 Shaw Road CITYISTATEIZIP: Stockton J CA/ 95215 <br /> PHONE(1), -209-467-1"0 PHONE(2)c: 209-623-7200 FACSIMILE. 209-467-111 <br /> TENTATIVE"APPOINTMENT DATE: ASAP Tirn®: <br /> (Phase 311OW 10 business days from date of appilcatl0i submittal-"Tentative only-must be confirmed) <br /> ❑ <br /> CHECK BOX TO EXPEDITE R U 3T-$125 F K ONLY) REQUEST'PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT _Zdo DATE�/ [n•-Ls? <br /> Electronic Information: ❑List❑Map—Desarlptlon: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name city <br /> i Unit 1 <br /> 1• 604 West Lodi Avenue jLodl <br /> \ <br /> 2. 508 West Lodi Avenue <br /> K � I Unit 2 <br /> 3. 305 South Hutchins Street Lodi <br /> 4. _ <br /> S. `p unit 3 <br /> 1 �r� P:1 <br /> a. t CAe L � Unit e e.✓ 1h/ b,,L)b�L t <br /> 7_ <br /> 9. Units ( ' <br /> 10. <br /> v Unit 8 <br /> Specific Date Range of Information Requastedc From all to ' <br /> ENVIRONMENTAL.HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP$ITE(LOP) ❑HOUSING ABATEMENT EK SOLID WASTE FACILITY/VEHICLE <br /> Q OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY Q WASTE TIRE <br /> X❑UNDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL Q DAIRY <br /> x❑HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH <br /> Q TIERED PERMITTED FACILITY WASTEWATER TREATMENT PLANT <br /> ❑TIERED BRMI00Y TED FACILITY <br /> ❑MOTEL/HOTEL [�PUMPER TRUGKIYARDICHEMICALT04LE;TS <br /> [I MEDICALWASTE FACILITY Q COMPLAINT RECORDS Q T14ERND 3E ARPLICATION SITES17OOTHER(PleASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-6:00PM(EXCLUDING HOLIDAYS) <br /> 1. hist UP to tan addressee In the apace above. Select the types)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 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 approximately tan(10) <br /> days after receipt of application. The files will be held for a maximum of five_busines's 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 avallabla 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 /> EHD USE ONLY <br /> CHO to-0s <br /> W7/97 <br /> Received Time Nov, 2`6. 2012 10.49AM No. 1689 <br />
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