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■ DEHU LOU NUMBER <br />r ��`� SAN JOAQUIN COUNTY <br />EORONMENTAL HEALTH DEPAR*ENT <br />FEb i W 2011 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax. (209) 464-•0135 Web: www.sigov.org/ehd 85 04 <br />- ,�irfiA ON SAL t-iE�-T� <br />PEXMIT/-0ERknES PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: Andrew Kim BUSINESSIAGENCY: ENCON Solutions Inc - <br />ADDRESS: 3255 Wilshire Blvd #1508 CITYISTATEIZIP: Los Angeles, CA 90010 <br />PHONE (1): 213-380-0555 PRONE (2): FACSIMILE. 213-380-0505 <br />Ti=N7ATIVE"APP0INTMENT DATE: Time: <br />(Please allow 16 business days from date of application submittal - `7entative only - must be confirmed) <br />❑ CHECK Box TQ EXPEDITE REQUEST - $125 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT <br />Electronic Information; ❑ List ❑ Map — Description: <br />DATE 2-13-17 <br />EHD USE ONLY <br />I _E] Unit 1 <br />n-� I' ✓V <br />f S7V1 !f i ® Unit 2 <br />--- -- <br />Y s <br />4nit 3 <br />c,O Ii;+h Wiaip <br />7. _ _ - .s rvl tj CAJ •17 112- ) -i— f� K <br />8. �nQ/iiv` fZCt. 0 <br />Specific Date Range of Information Requested: From Any to An <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />Urr+4 <br />tjf— <br />Unit S <br />I� 4 <br />Unft-G <br />® UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ® MEDICAL WASTE FACILITY ® SOLID WASTE FACILITYI�I(¢LbY <br />® OTHER CLEANUP SPFE (NON -LOP) ❑ HOUSING AEIATEMENT ® WASTE TIRF <br />® UNDERGROUND TANK (MONITORING)REMOVAL) ❑ FOOD FACILITY ❑ DAIRY <br />® A13DVEGROUNo TANK ❑ CHICKEN RANCH/ DOG KENNEL ® WASTEWATER TREATMENT PLANT <br />® HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑ MOTELIHOTEL ® PUMPER TRUCOYARDiCHEMICALT&LETS <br />® TIERED PERMITTED FACILITY ❑ POOLISPA ® LAND Us APPLICATION SITES <br />❑ TAT ooiBov PIERCING ® COMPLAINTIRESPONSE RECORDS ❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:00PM (EXCLUDING HOLIDAYS) <br />i. List up to ten addresses in the space above. Select the type(s) of files from the fist 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 fila addresses, contact the FHD_ 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 EH0 staff may not be immediately available for review. A new application may be <br />suDmltted 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 bV the same Applicant may require a $125 deposit prior to review_ ^-"EbXED AREA - EHD USE ONLY—, <br />'7, <br />rl 1?arnrrlc nr(%vidi-ri b gfa_PPP rornniiatp. Staff Name-, <br />Received Tlr e—Feb, 13."2017— �5:01PNF--No, 0832 <br />1.� <br />4. <br />4 <br />_ FILE ADDRESS <br />Street - -� -- Street Name <br />930 m ..._'_.Ea ... ...-•----.._.-.� -.. � - <br />st Charter Way <br />DL <br />I <br />----�-----I"— ----- - <br />City <br />Stockton <br />5. <br />6. <br />DATE 2-13-17 <br />EHD USE ONLY <br />I _E] Unit 1 <br />n-� I' ✓V <br />f S7V1 !f i ® Unit 2 <br />--- -- <br />Y s <br />4nit 3 <br />c,O Ii;+h Wiaip <br />7. _ _ - .s rvl tj CAJ •17 112- ) -i— f� K <br />8. �nQ/iiv` fZCt. 0 <br />Specific Date Range of Information Requested: From Any to An <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />Urr+4 <br />tjf— <br />Unit S <br />I� 4 <br />Unft-G <br />® UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ® MEDICAL WASTE FACILITY ® SOLID WASTE FACILITYI�I(¢LbY <br />® OTHER CLEANUP SPFE (NON -LOP) ❑ HOUSING AEIATEMENT ® WASTE TIRF <br />® UNDERGROUND TANK (MONITORING)REMOVAL) ❑ FOOD FACILITY ❑ DAIRY <br />® A13DVEGROUNo TANK ❑ CHICKEN RANCH/ DOG KENNEL ® WASTEWATER TREATMENT PLANT <br />® HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑ MOTELIHOTEL ® PUMPER TRUCOYARDiCHEMICALT&LETS <br />® TIERED PERMITTED FACILITY ❑ POOLISPA ® LAND Us APPLICATION SITES <br />❑ TAT ooiBov PIERCING ® COMPLAINTIRESPONSE RECORDS ❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:00PM (EXCLUDING HOLIDAYS) <br />i. List up to ten addresses in the space above. Select the type(s) of files from the fist 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 fila addresses, contact the FHD_ 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 EH0 staff may not be immediately available for review. A new application may be <br />suDmltted 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 bV the same Applicant may require a $125 deposit prior to review_ ^-"EbXED AREA - EHD USE ONLY—, <br />'7, <br />rl 1?arnrrlc nr(%vidi-ri b gfa_PPP rornniiatp. Staff Name-, <br />Received Tlr e—Feb, 13."2017— �5:01PNF--No, 0832 <br />