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ATE RECEIVED SAN JOAQUIN COUNTY I <br /> AJ D EN MENTAL HEALTH DEPARTMOT D O <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 D <br /> r APR 1 ] �Sephone. (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> ENIhPi)NIMENTALHsALT PUBLIC RECORDS RELEASE APPLICATION <br /> LIN <br /> n.r•- <br /> L _ <br /> APPLICANT: Frank Trinidad BUSINESSIAGENCY: Odic Environmental <br /> ADDRESS: 3255 Wilshire Blvd#1510 CITYISTATEIZIP:Los Angeles <br /> PHONE(1): 213-3804090 PHONE (2): 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 EXPEDITE REQUEST- 25 F $H R CHECK ONLY)-REQUEST PROCESSED IN 3 8 SINES Y <br /> SIGNATURE OF APPLICANT % DATE Ll <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City 171 unit 1 <br /> 1. 4881 State Route 99 Stockton <br /> 2, 4608 E.Waterloo Rd Stockton I�Ouh;t3 '�?fl ,O Unez <br /> q, O'UnIt3 <br /> 5. C �fl <br /> 6. .-0'nit4 <br /> 7. <br /> 9. ❑Unit 5 <br /> 9. <br /> 10. fO Umt e <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONM AL HEALTH DEPARTMENT FILES RDAIRY <br /> tHATTOOIBODY <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) MEDICAL WASTE FACILITY SOLID WASTE�F1ACILITYNEHICLE1 <br /> THER CLEANUP SITE(NON-LOP) HOUSING ABATEMENT WASTE TIRE hj I�'J/GGty��,,-✓ 1N-NDERGROUND TANK(MONITORINGIREMOVALb( E]FOOD FACILITY q-LS-13 <br /> BOVEGROUNDTANK �- ❑CHICKEN RANCH/DOG KENNEL WASTE WATER TRrAA M TPLANT <br /> AZARDOUSWASTEIHAZARDOUS MATERIALS ❑MOTEUHOTEL UMPERTRUCKIYARDICHEMICALTOILETS <br /> IERED PERMITTED FACILITY P. ❑POOUSPA LAND USE APPLICATION SITES <br /> PIERCING ❑COMPLAINTIRESPON8E RECORDS ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY�FRIDAY 8:00 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 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. **SOXED AREA-EHD USE ONLY-1 <br /> ® 51S G c�job. <br /> r <br /> r-1 D.......rte rr.3l.iAnA h.f C4aff„PPP r'_mmnldfn'Staff Name: <br /> Received Tim Apr. 16. -2013— 9: 32PFNo, 2868 914+2 <br />