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_ M �[: EHD LOG NUMBER <br /> DI g V«�Uj SAN JOAQUINCOUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> JUN 0 9 2009 600 E. Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209)464-0135 Web: www.sjgov. <br /> EN' IRDNIMENT HEALTH 3 <br /> PERM ITSERVI%ES PUBLIC RECORDS RELEASE APPLICATIO <br /> APPLICANT: Abby RaccOBUSfNESSlAGENCY: Live Oak GeoEnvironmental <br /> ADDRESS: 407 W. Oak St., Lodi, CA 95240 <br /> PHONE(1): (209)369-0375 PHONE(2): FACSIMILE: 209 369-0375 <br /> TENTATIVE"APPOI NTMENT DATE: June 23, 2009 Time: 9:00 am <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDfTE REQUEST-$95.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT Ay {' DATE Q I'i l0 <br /> i <br /> Electronic information: ❑List L] Map—Des6ription: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑ Unit 1 <br /> I. 19690 N. St. Rt. 99 E. Frontage Acampo <br /> 2• 19690 N. Highway 99 Acampo Unit 2 <br /> 3. 19501 N. Highway 99 SQ 4a Acampo <br /> Unit 3 \ <br /> 4• 19256 N. Highway 99 Acampo dpo <br /> 5. 18846 N. Highway 99 5 Q'�R- Lodi <br /> Unit 4 <br /> 6. i`� _ ': f�i .} :,nom i <br /> 7. <br /> Unit 5 <br /> k 8 <br /> 9. <br /> ❑ Unit 6 <br /> 10. <br /> Specific Date Range of Information Requested: From all available. to <br /> ENVIRONMENTAL.HEALTH DEPARTMENT FILES <br /> 0 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITYNEHICLE <br /> 0 OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY 0 WASTE TIRE <br /> f 0 UNOERGROUNDTANK(MONITORINGIREMOVAL) ❑DOG KENNEL 10 DAIRY <br /> Q HAZARDOUS WASTE GENERATOR 12 CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑TATTOOfBODY PIERCING '❑POOL/SPA '0 LAND USE APPLICATION SITES <br /> ❑MEDICAL WASTE FACILITY 13 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW -:MONDAY-FRIDAY 8:00 AM-S:OOPM - 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 209 464-0138 or mail to the address Indicated above. Address <br /> F 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 /> 1 days after receipt of application. The files will be held for a maximum of five business days f6r 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 re4ulre a$95.00 deposit prior to review. <br /> i <br /> EHD USE ONLY <br /> i <br /> EHD4MS 9113(2006 web <br /> 1 <br />