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RECEIVED 17078776 ANTON PAGE 01/01 <br /> x L <br /> DATE RECEIVED SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> JUN 0 7 2011 <br /> ENVIRONMENTAL HEALTH bEPARTMENT 60;str <br /> ENVIRONMENTAL HEALThrI 600 East Main St. Stockton, CA 95202-3029 <br /> PERMIT/SERVICES elepftone: (209)468-3420 Fax: (209)464-0138 Web:vdwwsjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Kenneth Anton BUSINESS/AGENCY: Anton Geological <br /> ADDRESS: P• O. 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 10 business days from'-data of application I ai-•Tentadve only-must be confirmed) <br /> ®CHECK BOX TO EXPEDITE:REQUEST-$,y22 A$ (O 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 /> $treat 4 street Name City <br /> 1. 6421 Capital Avenue Lodi umtt <br /> 2- 6437 W. Banner Street Lodi <br /> 14749 Unit2 <br /> 3. N. Thornton Road Lodi / <br /> - — - �1 — <br /> 4. - <br /> 5. <br /> Unita <br /> S. Unit 4 <br /> 7. <br /> S. <br /> 9. <br /> untie <br /> 10. <br /> ❑unit a <br /> Specific Date Range of Information Requested. Prom <br /> ENVIRONMENTAL WEALTH-DEPARTMENT <br /> ® to <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT Q SOLID WASTE FAGI.ITYNEHICLE <br /> El OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY <br /> ©UNDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL WASTE TIRE <br /> ❑DAIRY <br /> N HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> []TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKNARDICHEMICAL TOILETS <br /> ❑TATTOOIBODY PIERCING ❑POOL/SPA <br /> ElMEDICAL WASTE FACILITY Ll LAND USE APPLICATION SITES <br /> (PLEASE SPECIFY) <br /> V <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:DopMEXCLUDING HOLIDAYS <br /> 1. List up to ten addresses In the space above. Select the type(s)of filen from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(2091404-0138 or mail to the address indlc rod 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 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 he reorganized by EHD staff At the expense of the applicant. <br /> Future file reviews by the sums applicant may require a$12.2 deposit prior to review. <br /> EHD use ONLY <br /> eRc 49-De <br /> aln9Me <br />