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01/22/2015 4 : 56 : 32 PM —0600 Terracon Fax Server 1,,= , s PAGE 2 OF 2 <br /> DATE RECEIVED S EHD LOG NUMBER <br /> SAN JOAQUIN COU <br /> RECEIVED ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> JAN 23 20jrTelephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> "j:jhjhAr- jAI HEAQH PUBLIC RECORDS RELEASE APPLICATION <br /> ppFFRRMM��TT/(SERVICES <br /> APPL"IWT:Heather Shaddox BUSINESS/AGENCY:Neil O. Anderson &Associates <br /> ADDRESS: 902 Industrial Way CITY/STATE/ZIP:Lodi, CA 95240 <br /> PHONE(1): 209-367-3701 PHONE(2):209-747-1000 FACSIMILE:209-333-8303 <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECKONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE January 22,2015 <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street 9 Street Name City El unit 1 <br /> 1. 1127 Industrial Way Lodi <br /> 2. 1301 Industrial Way Lodi p�unit 2 <br /> 3. 1025 Industrial Way Lodi <br /> 4. 1250 Thurman Street Lodi Ejunit 3 <br /> 5. 810 S Cluff Avenue Lodi <br /> 6. 1150 Thurman Street Lodi /�rl_ Q-tsnit 4 <br /> 7. 1122 Industrial Way Lodi <br /> 8. —70- 1 `( ❑ Unit 5 <br /> 9. <br /> 10. 0-Unit 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ®MEDICAL WASTE FACILITY ®SOLID WASTE FACILITYNEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT WASTE TIRE <br /> ®UNDERGROUND TANK(M ONITORINGIREMOVAL) ❑FOOD FACILITY ® DAIRY <br /> ®ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL WASTEWATER TREATMENT PLANT <br /> HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ®PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ® TIERED PERMITTED FACILITY ❑POOLISPA ®LAND USE APPLICATION SITES <br /> ❑TATT001BODY PIERCING ®COMPLAINT/RESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to (209)464-0136 or mail to the address indicated 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 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 /> 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. ***BOXED AREA-EHD USE ONLY <br /> Received Timer(Jan. 22. ly20f5ff 2;49PNbiNo. 7940slaffName: <br /> WA„1 <br />