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I "TE RECEIVED <br /> �, SAN JOAQUIN COUNTY <br /> REOEIV D ENV&NMENTAL HEALTH DEPARTMOT Qg <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 DD <br /> r APR 17 & : (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> lephone <br /> M40ONMENTALHEALT PUBLIC RECORDS RELEASE APPLICATION <br /> REDR.a•• <br /> _y <br /> APPLICANT: Frank Trinidad BUSINESSIAGENCY: Odic Environmental <br /> ADDRESS: 3255 Wilshire Blvd#1510 CITYISTATEIZIP: Los Angeles <br /> PHONE (1): 213-380.0090 PHONE(2): FACSIMILE: 213-380-0505 <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-'7entative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST- 25 F SH R CHECK ONLY)-REQUEST PROCESSED IN 3 B SINES A <br /> SIGNATURE OF APPLICANT DATE LJ� <br /> Electronic Information: ❑ List 0 Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# street Name City ❑Unit 1 <br /> , <br /> 1. 4881 State Route 99 Stockton <br /> 2. 4608 E.Waterloo Rd Stockton 00U.4Lt 3 'l7 ,�unu2 <br /> 3. <br /> 4 p'Unit 3 <br /> 5 <br /> 0. f 2.11nit 4 <br /> 7. <br /> 8 ❑Unit 5 <br /> 9. <br /> 10 Unit 6 <br /> Specific Date Rang,of Information Rega,stad: From to <br /> ENVIRONM AL HEALTH DEPARTMENT FILES <br /> JADOVEGROUNi) <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) MEDICAL WASTE FACILITY SOLID WASTE FACILITYNE/HIC�L�E <br /> THER CLFANUP SITE(NON-LO P) HOUSING ABATEMENT ASTE TIRE �h IBJ /& 1071 t3- <br /> NDERGROUND TANK(MO NITORINGIREMOVALV ❑FOOD FACILITY 91DAIRY y-Z-S-I j <br /> TANK - 0 CHICKEN RANCH/DOG KENNEL WASTE WATER TRFA M TPLANT <br /> AZAROOUS WASTE MATERIALS� ❑MOTELIHOTEL <br /> Ur <br /> TRUCKIYAROICHEMICAL TOILETS <br /> IERED PERMITTED FACILITY - ❑POOLISPA LAND USE APPLICATION SITES <br /> ATTOOIBODY PIERCING F]COMPLAINTIRESPONSE RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY�FRIDAY 6:00 AM-S:OOPbI (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 W the add ress indlcat onabovelved afterAddress <br /> e. <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. App ' <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 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 review. * BOXED AREA.EHD USE ONLY^• �T.Q� <br /> 0 3515 G- " �to�. <br /> 4R km <br /> Mf C*1ff-PPR Cmmnldta'Slaff Name: <br /> Received Tim Apr. 16. -2013— 9: 32PFNo. 2868 914112 <br />