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DATE RECEIVEDEHD LOG NUMBER <br /> vl� i A N _ 'n SAN JOAQUIN COUNTY <br /> 1r��V ENVIRONMENTAL HEALTH DEPARTMENT <br /> '0Irorm� 1868 East Hazelton Avenue,Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Curtis Payton BUSINESS/AGENCY: ERAS Environmental <br /> ADDRESS: 1217 35 Street CITY/STATEIZIP: Sacramento,CA 95816 <br /> PHONE(1): 916-267-1246 PHONE(2): FACSIMILE: <br /> TENTATIVE"APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-'Tentative only-must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUES 125 EE( SHO C E KO -REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 9 April 2013 <br /> Electronic Information: ❑List❑Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Streetp Street Name city Unit <br /> 1, 103 E.Elm Street Lodi (1f;r- <br /> 2, 114 N.Main Street Lodi S,o ❑Unit 2 <br /> 3, 125 N.Stockton Sheet Lodi i <br /> 4. 27 E.Locust Street Lodi / Dwrunit3 1 <br /> 5. 224 N.Main Street Ro joa V-' Lodi t,52,% kJCR(o.-*j (...6-1) +� <br /> 6. 230 N. Stockton Street Lodi L Unit4 <br /> 7. 210 N.SacramentoStreet AD fir Lodi 2-0<b <br /> O+i <br /> S. 120 E.Lockford Street Lodi ❑Unit 5 <br /> 9. 316 N.Main Street rw,,ft AL_ Lodi 70 <br /> 10. ❑Unit e <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICALWASTE FACILITY ❑SOLID WASTE FACIUTYNEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOusiae ABATEMENf ❑WASTETIRE <br /> ®UNDERGROUND TANK(MONITORING/REMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ❑ABOVEGROUND TANK ❑CHICKEN RANCHI DOG KENNEL []WASTEWATER TREATMENT PLANT <br /> ®HAZARDOUS WASTEIHAZARDOUs MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICALTOILETS <br /> ❑TIERED PERMIrrED FACILITY ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOO/BODY PIERCING ❑COMPLAIMIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List no 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 /> 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 exgense ofthe applicant. <br /> Future file reviews by the same applicant may require a$125 deposit prior to review. BXEDAREA•EHD USE ON <br /> ❑ Records provided by Staff-PPR Complete.Staff Name: <br /> 91912 <br /> 1 EHO 49-06 <br />