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EHD LOG NUMUt-K <br /> NATE RECEIVED SAN SAN JOAQUIN COUNTY <br /> ■i REEIVt) ENVIRONMENTAL HEALTH DEPARTMENT <br /> ■� <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-623 <br /> ■■ JUM l `'T�y�glephone: (209) 468-3420 Fax: (209) 464-0138 Web: www,sjgov.org/ehdQ� <br /> EWROFi. &TALf1l1 T� CATION v N� <br /> PE�IITrs�'�S PUBLIC RECORDS RELEASE APPLI <br /> APPLICANT: Andrew Kim <br /> BUSINESS/AGENCY:— ENCON Solutions Inc. <br /> CITYISTATEIZIP: Los Angeles, CA 90010 <br /> ADDRESS: 3255 Wilshire Blvd 41508 FACSIMILE:213-380-0505 <br /> PHONE (1): 213-380-0555 PHONE (2): <br /> Time: <br /> TENTATIVE*APPOINTMENT DATE: <br /> (Please allow 10 business days from date of application submittal 'Tentative only-must confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REOUE -S12 FEE(CASH CHECK ONLY)-REQUEST PROCESSED EIN 3 BUSINESSG18AYS `I <br /> SIGNATURE OF APPLICANT <br /> Electronic Information: ❑ List❑ Map--Description: <br /> EHD USE ONLY 2 p <br /> FILE ADDRESS _�� <br /> Street ft <br /> Street Name City <br /> Trac S.eo>5n-:I"-G( <br /> 1, 25432 South Schulte Road y It,-k-L_Lk <br /> Trac <br /> 2NIT. 25460 South Schulte Road y5,.) <br /> 3. <br /> 5. <br /> PRO 5 317 x-11— VA M — ✓ <br /> 9. <br /> 10. <br /> Specific Date Range of Information Requested: From <br /> An to Any <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES SOLID WASTE FACILITYNEHICLE <br /> ZUNDERGROUND TANK(UST)CLEANUP SITE(LOP) Z MEDICAL WASTE FACILITY WASTE TIRE HOUSING ABATEMENT <br /> ®OTHER CLEANUP SITE(NON-LOP) FOOD FACILITY ❑DAIRY <br /> ®UNDERGROUND TANK(MONITORING/REMOVAL) CHICKEN RANCHI DOG KENNEL ®WASTEWATER TREATMENT PLANT <br /> ®ABOVEGROUND TANK MOTE1IHOTEL ®PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ®HAZARDOUS WASTEIHAZARDOUS MATERIALS 0 MOTELIPOOL/SPA ❑C LAND USE APPLICATION SITES <br /> ®TIERED PERMITTED FACILITY OTHER PLEASE SPECIFY) <br /> ❑TATTOOIBODY PIERCING COMPLAINTIRESPONSE RECORDS ❑ <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 types)of files from the list above by checking the appropriate <br /> ran(es). Atleast one fie not be a cel ted-for additional aassistance with file AaddO138 ress sr contact themail to the aEHD SApplicationss indicated above. <br /> Address <br /> selected. Fax to received after <br /> range will P n appointment for review <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD rwill <br /> receipt of application. The flies will be held for a maximum of five business days for review. Appointments be confirmed approximately ten g10) <br /> if any EHID files exist. A <br /> days aft p <br /> should be scheduled accordingly. <br /> EHD staff may not be immediately available for review. Anew application may be <br /> 3. A file that is actively being worked on by <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. ReOXEAREA•EHD USE ONLY— <br /> Future <br /> zff Name-. .. 9r.u,:�No. 375GSta <br /> R? ivd irr,,rJun. 2i. b201811 1 : tiOM� j <br /> EHD A9-06 <br />