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CP'iU LVb IVVrvio�r� <br /> llipATERECEIVED SAN .JOAQUIN COUNTY <br /> son ENVIRONMENTAL HEALTH DEPARTMENT <br /> Inn 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: '''Andrew Kim BUSINESS/AGENCY: ENCON Solutions Inc. <br /> ADDRESS: 3255 Wilshire Blvd#1508 CITYISTATE/ZIP: Los Angeles, CA 90010 <br /> PHONE (1): 213-380-0555 PHONE (2): <br /> FACSIMILE:213-380-0505 <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 r=XPEDITE BEQUEST- I FEE(CASH OR CH LY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT �' �---- DATE 12-19-1�} <br /> ' <br /> Electronic Information: ❑ List ❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street fk Street Name City ❑ Unit 1 <br /> F22. <br /> 11180 Vallejo Court French Camp <br /> nit 2 <br /> 3. <br /> Unit 3 <br /> 4. <br /> 5. <br /> fa. <br /> unit G <br /> 7. <br /> 80 Unit 5 <br /> 9. <br /> 10. Unit <br /> specific Date Range of Information Requested_ From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> Z UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 MEDICAL WASTE FACILITY SOLID WASTE FACILITYNEHICLE <br /> ®OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT ®WASTE TIRE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY ❑DAIRY <br /> ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ®WASTEWATER TREATMENT PLANT <br /> HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL PUMPER TRUCK/YARD/CHEMICAL TOILETS <br /> ®TIERED PERMITTED FACILITY ❑POOUSPA ®LAND USE APPLICATION SITES <br /> F1 TATTOOI130DY PIERCING LA COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PFRMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 5:00 AM-5:00PM (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 raceipt of application. The files will be held for a 111aximurn 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 neer application may be <br /> Submitted when the file Is available. <br /> 4. Any file not returned in the sarna 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 $125 deposit prior to raviewa :BOXED AREA-EHD USE ONLY-' <br /> Received TimerDec 19, M014'h 1 . 50ll°No. 7756— -- 914112 <br />