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SANY <br /> j0AU 4* Envirorirnen,_.Mealth Department <br /> C O U i\,I T Y----- PUBLIC RECORDS RELEASE APPLICATION <br /> SUBMIT BY EMAIL <br /> EHD LOG NUMBER: ?13-50 ) <br /> APPLICANT: Frank Trinidad BUSINESS/AGENCY:odic Environmental <br /> ADDRESS: 3255 Wilshire Blvd1510 CITY/STATE/ZIP:Los Angeles,CA 90010 <br /> PHONE (1): 213-380-0090 PHONE(2): FAX OR E-MAIL: frankt@odicenv.com <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT DATE 08-09.18 <br /> 1. List up to ten addresses in the space below. Address ranges WILL NOT be accepted. Select the type(s)of files from the <br /> list below by checking the appropriate box(es). At least one file type MUST be selected. Fax to (209)464-0138. (nail to the <br /> address indicated below.or email to info(cDslcehd.com. Applications received after 3:0 III pr Text <br /> business day. pp lr[Ig2. For assistance in identifying the nature and content of EHD records, please contact EH at hebe <br /> 3. 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 /> 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 S152 deposit prior to review. �3 <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) <br /> Electronic Information: ❑ List E Map— Description: <br /> Specific Date Range of Information Requested: From 1950 to _0)lc <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT ( p y 9 p ) EHD U E �M��_,Y <br /> FILES (Specific addresses onlyaddress ran es will not be acce ted <br /> Q Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) ❑CONSUMER <br /> Cleanup Site(Non-LOP) <br /> 1868 E! Pinsl Dr Stockton <br /> Q Hazardous Waste DAIRY <br /> ®Tiered Permitted Facility 2 <br /> Q Aboveground Tank <br /> Q UST (Monitoring/Removal) jo PWS <br /> ® Hazardous Materials 3 <br /> ® Spill/Release Response <br /> WATER QUALITY <br /> Solid Waste Facility/Vehicle 4 ❑ <br /> Food Facility <br /> Pool/Spa ❑SITE MITIGATION <br /> Dairy 5 <br /> Q Land Use Application Sites <br /> ®Septic Pumper Truck/ E] <br /> Yard/Chemical Toilets r <br /> f <br /> Q Wastewater Treatment Plant C ❑CUPA <br /> ❑Housing Abatement 7 r AST I HM/HW <br /> ❑Motel/Hotel <br /> F1 Chicken Ranch/Dog Kennel L r ❑CUPA <br /> 8 �, UST <br /> Q Medical Waste Facility •' <br /> Tattoo/Body Piercing <br /> XSouoWAsrE <br /> ®Waste Tire a <br /> ®Complaint <br /> E]Other(Please Specify): ❑AccouNTING <br /> 10 <br /> ***BOXED AREA-EHD USE ONLY*** <br /> ❑ Records provided by Staff-PPR Complete. Staff Name: EHD 48.06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />