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03/27/2012 14: 49 FAX I�j001/001 <br /> BATE RECEIVED EHD LOG N!�rn7c <br /> ■ _ SAN .10AQUIN COUNTY <br /> ' 'C r, I VE � ENVIRONMENTAL HEALTH DEPARTFAF Popy <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> AU "j ?017Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Jim Helge BUSINESS/AGENCY: Enercon Services, Inc. <br /> ADDRESS: 3434 Marconi Avenue, Suite C CITYISTATE/ZIP: Sacramento, CA 95821 <br /> PHONE (1): 916-480-0205 PHONE(2): 916-480-9228 FACSIMILE: 916-480-0603 <br /> TENTATIVE"APPOINTMENT DATE: 9-10-2012 Time- 1:00 PM <br /> (Please allow 10 business days from date of application submittal-'T"entafive only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCE55ED 1N 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City _ Unit 7 <br /> 1. 1065 East Turner Road Lodi <br /> 2. 1105 East Turner Road Lodi u Dlunit2 <br /> 3. <br /> 4, P y p unit 3 <br /> 5. <br /> 6. Unit 4 <br /> 7. <br /> g. = unit 5 <br /> 9. <br /> 10, El Unit 6 <br /> Specific Date Range of Information Requested: From 1900 to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ❑VUNDERGROUND TANK(UST)CLEANUP SITE(LOP) E HOUSING ABATEMENT SOLID WASTE FACILITYNEHICLE <br /> [J OTHER CLEANUP SITE(NON-LOP) [ TOOD FACILITY [}WASTE TIRE <br /> 2rGNDERGROUND TANK(MONITORING/REMOVAL) ❑DOG KENNEL ❑DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH WASTEWATER TREATMENT PLANT <br /> &TIERED PERMITTED FACILITY [P]MOTELIHOTEL ffLJPUMPER TRUCKIYARDICHEMICALToILETS <br /> F1TATTOo/BODY PIERCING OOLISPA j.AND USE APPUCATION SI p5 0 <br /> 'MEDICAL WASTE FACILITY COMPLAINT RECORDS [0OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING OLJ AY5)CoWgZ� <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 (249)464-013@ or mail to the address indicated abyve. Address <br /> ranges will not be accepted-for addltlonal assistance with file addresses, contact the.EHD. Applications received after <br /> 3:00 prn will be processed the next business day. <br /> 2. The EHD will notify the applicant If any END 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 /> 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 same applicant may require a $125 deposit prior to ravlew: <br /> EHL)USE OWL Y <br /> Received Time-Aug. 27. -2012- 3: 58PM-No. 0995 ar+n+ <br /> EHD!d-06 <br />