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i■ <br />- I UA7 R C ED • EHD LOO NUMBER <br />1 V SAN JOAQUIN COUNTY <br />lip <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />DEC 14 2012 600 East Main St. Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />ENVIRONMENTAL HEALTH PUBLIC RECORDS RELEASE APPLICATION <br />A <br />APPLICANT: Frank Trinidad BUSINESSIAGENCY: Odic Environmental <br />ADDRESS: 3255 Wilshire Blvd #1510 CITY/STATE/Zip. Los Angeles, CA 90010 <br />PHONE (1): 213-380-0090 PHONE (2): FACSIMILE --213-380-0505 <br />TENTATIVE* APPOINTMENT DATE: Time: <br />(Please allow 10 buslness days from date of application submittal-•Yanfative only - must be confirmed) <br />❑ CHECK BOX To EXPEDITE REQUEST $122 FEE (CASH C CK ONLY) -REQUEST PROCESSED IN 3 BLISI !`SS DAYS <br />SIGNATURE OF APPLICANTDATES <br />Electronic Information: ❑ List ❑ Map — Description: <br />❑FOOD FACILITY <br />FILE ADDRESS <br />EHD USE ONLY <br />it 1 <br />)OUS WASTE GENERATOR <br />Street# <br />Street Name City <br />1. <br />2615 <br />W. Grant Line Rd Tra <br />TAS 5 iA!o CQ(Gj CDrUji <br />u0Un1t2 <br />� Unit 2 <br />❑ OTHER (PLEASE SPECIFY) <br />E Unita <br />4. <br />5. <br />A Unit 4 <br />8' <br />7. <br />❑ Unit 5 <br />8. <br />9. <br />/ <br />p Unit 6 <br />10. <br />Specific Date Range of Information Requested: From <br />'ROUND TANK (UST)CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT <br />CLEANUP SITE (NON -LOP) <br />❑FOOD FACILITY <br />'ROUND TANK(MONITORINGIREMOVAL)�i <br />El Doe KENNEL <br />)OUS WASTE GENERATOR <br />El CHICKEN RANCH <br />PERMITTED FACILITI(�, <br />❑ MoTEVHoTEL <br />IIBODY PIERCING <br />❑ POOLISPA <br />1L WASTE FACILITY <br />❑ OTHER (PLEASE SPECIFY) <br />to / <br />rWA <br />OLIDWASTE FACILRYNEHICLE <br />A7TIREAIRYSTEWATERTREATMENT PLANT <br />UMPER TRUCKfYARDICHEMICAL TOILETS <br />❑ LAND USE APPLICATION STIES <br />WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:00PM (EXCLUDING HOLIDAYS) <br />1. List ue 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 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 $122 deposit prior to review. <br />,A <br />