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`t . EHD LOG NUMBER <br />DATE RECEIVED 0 SAN JOAQUIN COUNTY <br />91 <br />�/ of,-r�% 1,, y- v�� ENVIRONMENTAL HEALTH DEPARTMENT <br />c <br />1868 East Hazelton Avenue, Stockton, CA - 32 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 We E <br />go 1 Y/c)r <br />' <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: Tonya Scheftner <br />ADDRESS: 902 Industrial W, <br />BUSINESS/AGENCY: Neil O. <br />CITY/STATE/ZIP: Lodi. CA 95240 <br />PHONE (1): 209-367-3701 PHONE (2):209-770-0731 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 REQUEST - $130 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT 10=- k. 5111111.t�v" DATE September 24, 2014 <br />Electronic Information: ❑ List ❑ Map - Description: <br />FILE ADDRESS <br />EHD USE ONLY <br />[/Unit 1 <br />®UNDERGROUND TANK (UST) CLEANUP SITE (LOP) <br />Street # <br />Street Name <br />City.11 <br />1. <br />1200 <br />W. Vine #12 <br />Lodi <br />121 Unit 2 <br />2. <br />1235 <br />W. Vine #20 <br />Lodi <br />3. <br />1121 — <br />W. Vine #12 <br />Lodi <br />R�Unit3 <br />4. <br />2407 <br />W. Vine (a <br />Lodi <br />5. <br />2415 <br />W. Vine j�j�� f - <br />Lodi <br />2Unit4 <br />6. <br />1108 <br />Cardinal �� <br />Lodi <br />7. <br />1109 <br />Cardinal G� <br />Lodi <br />� ❑Unit 5 <br />8. <br />1110 <br />Cardinal <br />Lodi <br />9. <br />800 — <br />S. Lower Sacramento -M W, <br />Lodi <br />ul zunit6 <br />10. <br />1001 <br />York St. VA f�f <br />Lodi <br />Specific Date Range of Information Requested:- From <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT FILES <br />®UNDERGROUND TANK (UST) CLEANUP SITE (LOP) <br />® MEDICAL WASTE FACILITY <br />®OTHER CLEANUP SITE (NON -LOP) <br />❑ HOUSING ABATEMENT <br />® UNDERGROUND TANK (MONITORINGIREMOVAL) <br />❑ FOOD FACILITY <br />® ABOVEGROUND TANK <br />❑ CHICKEN RANCHI DOG KENNEL <br />® HAZARDOUS WASTEIHAZARDOUS MATERIALS <br />❑ MOTELIHOTEL <br />® TIERED PERMITTED FACILITY <br />❑ POOLISPA <br />❑ TATTOOIBODY PIERCING <br />® COMPLAINT/RESPONSE RECORDS <br />to r� <br />®SOLID WASTE FACILITYNEHICLE <br />® WASTE TIRE <br />® DAIRY <br />® WASTEWATER TREATMENT PLANT <br />® PUMPER TRUCKIYARDICHEMICAL TOILETS <br />® LAND USE APPLICATION SITES <br />❑ 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 - 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 expense of the applicant. <br />Future file reviews by the same applicant may require a $125 deposit prior to review. .-BOXED AREA,- EHD USE ONLY <br />f�} <br />1 ❑ Records provided by Staff -PPR Complete. Staff Name: I <br />