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1767877„ 276 ANTON PAGE 01/01 <br /> D tv <br /> DATE RECEIVED SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> JUN 0 7 2011 ENVIRONMENTAL HEALTH DEPARTMENT <br /> ENVIRONMENTAL HEALru 600 East Main St. Stockton, CA 95202-3029 <br /> PERMIT/SERVICES .telephone: (209)468-3420 Fax: (209)464-0138 Web: www.rjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Kenneth Anton BUSINESS/AGENCY: Anton Geological <br /> ADDRESS: P. O. BOX 370 CITYISTATE/ZIP: Elk, CA 95432 <br /> PHONE(1): (707) 877-3278 PHONE(2): FACSIMILE: (707) 877-3278 <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (please allow 10 business days from deka of application autut al-'Tantative only.must be oonFlrmad) <br /> ©CHECK BOX TO EXPEDITE REQUEST-$y2 AS C 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 /> $freetp Street Name City <br /> 1. 6421 Capital Avenue Lodi Unit1 <br /> 2, 6437 W. Banner Street Lodi <br /> 3_ 14749 N. Thornton Road Lodi un tz <br /> Unil3 �/ r <br /> 6. <br /> 7. <br /> - Unit4 <br /> a. <br /> 9. <br /> -- Unit 3 <br /> 10. <br /> ❑Unit 8 <br /> Specific Data Range of Information Requested: From <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ® to <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY ❑WASTE TIRE <br /> ©UNDERGROUND TANK(MONITORING/REMOVAL) ❑DOG KENNEL <br /> ®HAZARDOUS WASTE GENERATOR ❑DAIRY <br /> ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> C]TIERED PERMITTED FACILITY ❑MOTELIHOTEL <br /> ❑TATTOOIBODY PIERCING ❑POOL/SPA ❑LAND USEUMPER RUCKICATION SI MICACTOILETS <br /> C]LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY - ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> L 1.Ist uo 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(2091464-0138 or mail to theaddress iodic led abpve 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 receipt of application. The flies 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 file reviews by the some applicant may require a$122 deposit prior to review. <br /> EMD USE ONLY <br /> END 40-08 <br /> orrvgns <br />