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G1�D To: 12094640138 From: 19164800603 Date: 10/19/15 Time: 10:07 AM Page: 01/01 <br /> EHD LOG NUMBER <br /> ® & VED SAN .IOAQUIN COUNTY <br /> Oita ENVIRONMENTAL HEALTH DEPARTMENT <br /> OCT 19 2015 1868 East Hazelton Avenue, Stockton, CA 95205-6232 '� 1 <br /> T.I. phone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> tNVPERMk SE ERMC <br /> .I <br /> PUBLlC RECORDS RELEASE APPLICATION <br /> APPLICANT:_I ind-sey Brooke Norton BUSINESS/AGENCY: ENERCON Services <br /> ADDRESS: 1451 River Park Drive Suite 109 CITY/STATE/ZIP: conrFImeotn rA R..9815 <br /> PHONE (1): 916-480-0236 PHONE (2): 337-257-96 5 FACSIMILE: 916-480-0603 <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 lindsey horton DATE 10-19-15 <br /> Electronic Information: ❑List ❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City <br /> F33. <br /> West Larch Road TracyUnit t <br /> 171Unit 2 <br /> ❑ Unit 2H <br /> nit 3 <br /> 5. <br /> unit 4 <br /> SITE MITIGATION <br /> 8. <br /> 9. <br /> - ❑ UnR s <br /> 10. <br /> Specific Date Range of Information Requested: From <br /> to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES SOLIDWASTE FACILTTYNEHICLE <br /> ®UNDERGROUNDTANK(UST)CLEANUP SITE(LOP) ❑MEDICALWASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT E]®WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL WASTEINATE R TREATMENT PLANT <br /> MOTELIHOTEL PUMPERTRUCKIYARDICHEMICALTO[LETS <br /> HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑ LAND USE APPLICATION S[TES <br /> TIERED PERMITTED FACILITY <br /> ❑POOLISPA. <br /> ❑TATTOOIBODY PIERCING 916OMPLAINTIRESPONSE 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). - least one file type MUST be selected. Fax to (20 91 46 4-01 38 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 o EHD staff at the expensereview. "`BOXED AREA-- the applicant. <br /> EHD USE ONLY <br /> Future file reviews by the same applicant may require a$130 deposit prior to "" <br /> ❑ Records provided by Staff-PPR Complete. staff Name: <br /> Received Time—Oct. 19. -2015—lu: UTAWNo, 9819 <br />