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CEIVED <br /> SAN�JQAQI� Environmental Health Department <br /> —COUNTY—FEB 12 2018 PUBLIC RECORDS RELEASE APPLICATION 2) <br /> �r Prl to CSS .7 rn.y: hPrC 0 <br /> ENVIRONMENTAL HEALTH EHD LOG NUMBER: <br /> APPLICANTPE: Tamara Woods BUSINESS/AGENCY: Terracon <br /> ADDRESS: 902 Industrial Way cITY1STATErzIP:_Lodi CA 95240 <br /> PHONE(1): _209-269-8586 PHONE(2): FAX OR E-MAIL:tkwc)ods@terracon.com <br /> Please allow fu business days from date of application submittal for the records to be available. <br /> Staff will contact you to arranoe an annointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT 11, r , „I,.' , DATE 2-12-18 <br /> 1. List up to ten addresses in the space oelow. Aaaress ranges WILL NOT be accepted. Select the_type(s)of files from the <br /> list below by checking the appropriate box(es). At least one file type MUST be selected. Fax to(2091464-0138, mail to the <br /> address indicated below,or email to infona.sicehd.com. Applications received after 3:00 pm will be processed the next <br /> business day. <br /> 2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted below. <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$152 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:0013M(EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List❑ Map—Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT Y 9 accepted) EHD USE ONLY <br /> FILES (Specific addresses only,address ranges will not be acce ted <br /> ,e'Underground Tank(UST) Street# Street Name city <br /> Cleanup Site(LOP) f � ❑CONSUMER <br /> Z Other Cleanup Site(Non-LOP) t 330 Kettleman Lane I odi <br /> • Hy <br /> ZHazardous Waste p Onlay <br /> ❑Tiered Permitted Facility 3 100 W. Lodi Avenue LOBI <br /> ❑Aboveground Tank <br /> FrUST (Monitoring/Removal) ❑PWS <br /> ❑Hazardous Materials 3 420 I S. Pleasant Avenue _ Lodi <br /> M <br /> .B Spill/Release Response <br /> ❑Solid Waste Facility/Vehicle 4 I ntEE ouurtr <br /> 820 I S. Cluff Avenue Lodi <br /> F1 Food AM Food Facility � HM IOW NS� <br /> ❑Pool/SpaSME MII IRON <br /> Dalry 5 <br /> ❑ 25251 S. Hutchins Street Lodi <br /> ❑Land Use Application Sites M 5 '�' <br /> HOMING <br /> ❑Septic Pumper Truck l 6 902 I Industrial Way I Lodi <br /> Yard/Chemical Toilets h.NM <br /> ❑Wastewater Treatment Plant C a:.p NrCUPA <br /> ❑Housing Abatement r 420 Kettleman Lane Lodi AST/HM/HW <br /> ❑Motel/Hotel 10LP 1-kw MM <br /> ❑Chicken Ranch/nog Kennel 501 I Kettleman Lane I Lodi UST <br /> 9 <br /> ❑ <br /> Medical Waste Facility <br /> ❑Tatmo/aody Piercing 11 SOLID W.M <br /> ❑waste Tire E 514 I Kettleman Lane I Lodi <br /> 'Complaint M Kyle, <br /> ❑Other(Please Specify): ❑AccourvnrvG <br /> ,a 1025 (Industrial Way Lodi <br /> ""`BOXED AREA-EHD USE ONLY"* <br /> • I r; 2 'j •1}-I -EfrMIcJ� A cs�,,.cJ.rccr � ot- ;„ r.•,el of de w.,� � �{: ��. k?;, t'S— <br /> ❑ Records provided by Staff-PPR Complete. staff Name: EHD 4114)6 <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />