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.ITE RECEIVED ® SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> , EVG� �7 E® <br /> R <br /> VG �7 ENANMENTAL HEALTH DEPARTMINT j`, <br /> OCT 15 20x13 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> elephone: (209) 468-3420 Fax (209)464-0138 Web:www.sjgov.org/ehd <br /> EMIIRONMENTALHEALTH ( .,- ' <br /> PERMITISERUICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Frank Trinidad BUSINESS/AGENCY: Odic Environmental <br /> ADDRESS: 3255 Wilshire Blvd#1510 CITY/STATE/ZIP; 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-*Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST FEE(CC R CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT /-1 DATE 10-14-13 <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City <br /> ❑ unit 1 <br /> 1. 1405 California St Escalon U V HM'm A)(3C05o <br /> d1� 2• Unit 2 <br /> tW 3. <br /> Unit3 <br /> %( 5. <br /> 6. )/2� <br /> Unit 4 - <br /> 7. <br /> a. <br /> ❑ Unit 5 <br /> 9. <br /> 10. <br /> Unit 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 11 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) MEDICAL WASTE FACILITY 8011P WASTE FACILITYNEHICLE p yr <br /> OTHER CLEANUP SITE(NON-LOP) HOUSING ABATEMENT ASTE TIRE _6 <br /> LAO, <br /> TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY DAIRY 10.3 <br /> ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ASTEWATER TREATMENT PLANT <br /> HAZARDOUS WASTEMAZARDOUS MATERIALS ❑MOTELIHOTEL LIMPER TRUCKIYARDICHEMICAL TOILETS <br /> TIERED PERMITTED FACILITY_ ❑POOLISPA AND USE APPLICATION SITES <br /> ITATToo/BoDy PIERCING ❑COMPLAINT/RESPONSE 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)484-0138 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 he 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•"" <br /> /r L U� a 10� <br /> . . Q2H- <br /> 19 <br /> 10,31 QW epi2ficaw ✓ Q <br /> n n____.r � na efnr.n n • 6 <br /> taf Name:Re.eived Tme—Orct. 15.r-2013—' 2:50PWNo. 430 > <br /> erartz <br />