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DATE RECEIVED EHD LOG NUMBER <br /> (� �� SAN .IOAQUIN COUNTY <br /> "`'� L °" ENVIRONMENTAL HEALTH DEPARTMENT <br /> MAR1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �RON E � GQi�I Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> ERM/ E ERVITAL C ALTH PUBLIC RECORDS RELEASE APPLICATION <br /> FERi�IT/SERVICES <br /> APPLICANT: Abby RaCCo BUSINESS/AGENCY: Live Oak GeoEnvironmental <br /> ADDRESS: 407 W. Oak St. CITY/STATE/ZIP: Lodi CA 95240 <br /> PHONE(1): 369-0375 PHONE (2): 365-3222 FACSIMILE: <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 APPLICANT Abby Racco DATE-3-4-16 <br /> Electronic Information: ❑ List ❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> street# Street Name City <br /> r44. <br /> 21025 S. Carrolton Rd. Ripon •/!! <br /> 20991 S. Carrolton Rd. Ripon ❑ Unit <br /> 21399 S. Carrolton Rd. Ripon unit 2 <br /> 18832 E. Mello Ripon ❑Unit 2H <br /> 5. 19102 E. Mello Ripon x 3µM <br /> 6• 303 S. Reid Ave. Linden nit <br /> 7. 0 Reid Ave. (FA0018566, R00001869) Linden El unit 4 <br /> S SITE MITIGATION <br /> 9. <br /> 10. 0 Unit 5 <br /> Specific Date Range of Information Requested: From all availahlp 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(MONITORINGIREMOVAL) ❑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 /> ❑TATTOOIBODY PIERCING iR]COMPLAINTIRESPONSE RECORDS ®OTHER(PLEASE SPECIFY) SSCR for 303 S.Reid <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List uD to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(as). 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. ***BOXED AREA-EHD USE ONLY*** <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> 711115 <br /> EHD 48-06 <br />