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DATE RECEIVED 0 0 <br />EHD LOG /NUMBER <br />7 ; y SAN JOAQUIN COUNTY Uj <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenge, Stockton, CA 95205-6232 \0"o <br />`Telephone: (209) 468-8420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd sh <br />V <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: David Bole <br />ADDRESS: 104 Brack Drive <br />BUSINESSIAGENCY: Bole and Associates <br />CITY/STATE/ZIP: Wheatland, CA 95692 <br />PHONY (1): 530-415-6623 PHONE (2): 530-633-0117 FACSIMILE: 53D-633-0119 <br />TENTATIVE*APPOINTMENT DATE: 7116!13 Time: PM (1-5) <br />(Please allow 10 business days from date of application submittal -*Tentative only -must be confirmed) <br />❑ CHECK BOX TO EXPEDITE REQ 5 - $ FE A OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT DATE - r/ ---� 12 <br />Electronic Information: ❑ List ❑ Map — Description: <br />FILE ADDRESS <br />EHD USE ONLY <br />42 <br />0 Unit 1 <br />Street# Street Name <br />City <br />1. <br />6750 <br />South Longe Street <br />Stockton <br />1 _ <br />El Unit z <br />2. <br />7100 South Longe Street <br />Stockton <br />3. <br />7199 <br />South Longe Street <br />Stockton <br />GO) ­' <br />Unit 3 <br />4. <br />7679 South Longe Street <br />Stockton <br />5. <br />1621 <br />Citation Street <br />Stockton <br />r <br />J�ju it 4 <br />6. <br />1641 Citation StreetAl IF rwStockton <br />7. <br />6755 <br />Dixon St (C.E. Dixon St.) rr <br />Stockton <br />erp unit s <br />a. <br />5000 S. Airport Way <br />Stockton�. <br />E868 <br />Lockheed Court <br />Stockton <br />-f <br />AANI fly <br />©d!init s <br />1611 <br />JO7 <br />S.Airport Way <br />Stockton <br />Vi <br />Specific Date Range of Information Requested: From to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ MEDICAL WASTE FACILITY X LID WASTE FACiLITYIVEHICLE r <br />X OTHER CLEANUP SITE (NON -LOP) ❑ HOUSING ALSATEMENTX ASTE TiREtAg -h J ['� � t i ' <br />X UNDERGROUND TANK (MONITORING/REMOVALV El Fool) FACILITY DAIRY r° -7—/ 3 <br />XABOVEGROUND TANK v ❑ CHICKEN RANCH/ DOG KENNEL ❑ WASTEWATER TREATMENT PLANT <br />X HAZARDOUS WASTEIHAZARDOus MATERIAL4�` - ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARD/CHEMICAL TOILETS <br />XTIERED PERMITTED FACILITY POOLISPA ❑ LAND USE APPLICATION SITES <br />❑ TATTOOIBODY PIERCING oMPLAINTIRESPONSE RECORDS ❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8;00 AM-5:OOPM (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 feast 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 filas 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 />N `U'li(.4 Ije <br />. <br />[� EH Q 4846 ��o�- I - r3-1 '. 5 e. :•��arUAinic�lsk�l'pky � S ct Jul <br />Fe4' 0-,4,4P_ sic' -Pt)( irm'm Q. • <br />