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DATE RECEIVED _ SAN .IOAQUIN COUNTY a EHD LOG NUMBER <br /> Q �I -71'-j 0 ENVIRONMENTAL HEALTH DEPARTMENT <br /> I�L 1868 East Hazelton Avenue, Stockton, CA 95205-5232 sPace' <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:David Bole BUSINESSIAGENCY:Bole and Associates <br /> ADDRESS- 104 Brock Drive CITY/STATEIZIP:Wheatland,CA 95692 <br /> ` PHONE(1): 530.415-6623 PHONE(2):530-633.0117 FACSIMILE:530.633-0119 <br /> TENTATIVE'APPOINTMENT DATE: 7116113 Time: PM(1-5) <br /> (Please allow 10 business days from date of application submittal-•Tenlafive only-musf be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQ S -$ OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT i`J/( DATE <br /> Electronic information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑Unit 1 <br /> 1. 6750 South Longe Street Stockton /11 , IUo Lo(/7 <br /> 1� 2. 7100 South Longe Street Stockton oj I Q Unit 2 <br /> 3. 7199 South Longe Street Stockton o _ Q <br /> 4. 7679 South Longe Street Stockton 4\ 1 -) ,p Unit 3 i <br /> 5. 1621 Citation Street Stockton NO N� 9 <br /> 6. 1641 Citation Street 0 fry Stockton unit 4 <br /> 7. 6755 Dixon St(C.E.Dixon St.) �i Stockton /'�/ <br /> S. 5000 S.Airport Way Stockton R71 <br /> Unit 5 <br /> 9. On Lockheed Court Stockton M <br /> 10. 7611 S.Airport Way Stockton MP;P [34,!t 6 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑MEDICAL WASTE FACILITY //XX UD WASTE FACIUTYIVEHIICCLEE. <br /> YXXXTIEREL)PERMITTEi3FACILITYC;�— <br /> OTHER CLEANUP SITE(NON•LOP) ❑HOUSING ABATEMENT ( X�1 ASTETIRE�,I .{jIQLrwUNDERGROUND TANK(MONRORINGIREMOVAL)yt ❑FOOD FACILITY `�CI DAIRYABOVEGROUNDTANK v ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> HAZARDOUS WASTEIHAZARDOUS MATERIA116� ���❑--IIIMOTELHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ` yI POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑TATTOO180DY PIERCING OMPLAINTIRESPONSE 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)464-0136 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 /> 1 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-EHP USE ONLY <br /> 1 I ro L) W U Ps r 517 A+r 3 <br /> '7 r I 3518 o <br /> -7b con U s ' r <br /> 25 s <br /> EHD48.06 1-11-13 .. toll) 6)0107 In (.WI <br /> GI "il'.r ��f� /}, Q^� ( X/l'Qflq 4rY�UV'l?` <br /> 17 13 Ste u,cwaiLblli.F. � n rtMrnO F'(t..F.o. �. �:bq . ...,_dQ s«.e#) <br /> .? 1ort4@ <br /> -------------------- <br /> ---_ <br /> -- <br /> -- <br />