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----- --------- --= ____ -_z.. r----- ----- - ----- - --- - _z�_..-......-- .._ <br /> ------------------- -------------- <br /> FAIL'sG' M, y EHD LOG NUMBER <br /> I � SAN JOAQUIN COUNTY <br /> %/ ENVIRONMENTAL HEALTH DEPARTMENT14 <br /> 1` 1868 East Hazelton Avenue, Stockton, CA 95205-6232 q0 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Heather Shaddox BUSINESS/AGENCY:Petra logix Engineering <br /> ADDRESS: 26675 Bruella Road CITY/STATE/ZIP: Galt, CA 95632 <br /> PHONE (1): 209.747 .1000 PHONE(2): 209.400 . 5729 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 DATE 04/02/2015 <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City El Unit 1 <br /> 321 West Turner Road Lodi <br /> 2. (APN: 041-250-51) p unite <br /> 3. / 1 <br /> 4. Q Unit 3 <br /> 5. <br /> 6. Q Unit 4 <br /> 7. <br /> 8. O Unit 5 <br /> s. K� 5' A <br /> 10. ❑"Unit 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 0 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) [Z]MEDICAL WASTE FACILITYX❑SOLID WASTE FACILITYNEHICLE <br /> -1 OTHER CLEANUP SITE(NON-LOP) ❑x HOUSING ABATEMENT Q WASTE TIRE <br /> Q UNDERGROUND TANK(MONITORINGIREMOVAL) Q FOOD FACILITY ®DAIRY <br /> ®ABOVEGROUND TANK ®CHICKEN RANCH/DOG KENNEL Q WASTEWATER TREATMENT PLANT <br /> ®HAZARDOUS WASTEIHAZARDOUS MATERIALS ®MOTELIHOTEL gpUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ®TIERED PERMITTED FACILITY Q POOLISPA Q LAND USE APPLICATION SITES <br /> ®TATTOOIBODY PIERCING Q COMPLAINTIRESPONSE 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 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 /> 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 /> EHD 48-06 08/01/14 <br />