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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0526345
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SITE INFORMATION AND CORRESPONDENCE
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Entry Properties
Last modified
2/5/2019 3:57:12 PM
Creation date
2/5/2019 3:45:52 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0526345
PE
2957
FACILITY_ID
FA0017827
FACILITY_NAME
FLAG CITY SHELL
STREET_NUMBER
6437
Direction
W
STREET_NAME
BANNER
STREET_TYPE
ST
City
LODI
Zip
95242
APN
05532019
CURRENT_STATUS
01
SITE_LOCATION
6437 W BANNER ST
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
WNg
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EHD - Public
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R / /�8�`V� :� 17078773,2.76 ANTOH PAGE 01/01 <br /> GG <br /> DATE RECEIVED EHD LOG NUMBER <br /> JUN 0 7 2011 SAN JoAQUIN COUNTY : <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> ENVIRONMENTAL HEALTIII 600 East Main St. Stockton, CA 95202-3029 •d. <br /> PERMIT/SERVICES elephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.o g/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Kenneth Anton BUSINESS/AGENCY: Anton Geological <br /> ADDRESS: P. 0. Box 370 CITY/STATE/ZIP: Elk, CA 95432 <br /> PHONE(1): (707) 877-3278 PHONE(2): FACSIMILE: (707) 877-3278 <br /> TENTATIVE"APPOINTMENT DATE: Time: <br /> (Please allow to business days from date of appllcation i al-`Tenfadve poly-must he confirmed) <br /> ©CHECK BOX TO EXPEDITE REQUEST-_U22 AS (0 EST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE June 7, 2011 <br /> Electronic Information: ❑List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street i< Street Name CityT, 6421 Capital Avenue Lodi Unitt <br /> 2- 6437 W. Banner Street Lodi <br /> 3, 14749 N. Thornton Roaduna2 <br /> Lodi . <br /> 6. <br /> 7. Unit 4 <br /> 8. <br /> 9. UnK 3 <br /> 70. <br /> Specific Data Range of Information Requestad: From [7)unit a <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES b <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACIUTYNEWICLE <br /> D OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> ©UNDERGROUND TANK(MONITOMNG/REMOVAL) ❑DOG KENNEL ❑DAIRY <br /> ®HAZARDOus WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ❑TIERED PERMITTED FACILITY ❑MOTELIHOTEL <br /> El TATTDOIBODY PIERCING ❑POOLISPA ❑PUMPER TRUCNIYARO/CHEMICAL TDILEfS <br /> ❑ MEDICAL WASTE FACILITYOTWER(PLEASE SPECIFY) F-1LANDUSE APPLICATION SITES <br /> - ❑ � <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY B:00 AM-5:OOPM EXCLUDING HOLIDAYS , <br /> 1. List up to tan 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. 0 2 484.0138 or mall to the address indl AIed above. Address <br /> ranges will not be accepted-for additlonal 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 EMD files exist. An appointment for review will be confirmed approximately tan (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 fila reviews by the same applicant may require a.$122.deposit prior to review, <br /> ens use ONLY <br /> No 4s-oe <br /> o�aeno <br />
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