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DATE RECEIVED EHD LOG NUMBER <br />�%� �� SAN .10AQUIN COUNTY <br />l ENVIRONMENTAL HEALTH DEPARTMENT <br />- 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />'Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />0 Ev'-.0 (10 <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: David Bole <br />ADDRESS: 104 Brock Drive <br />BUSINESS/AGENCY: Bole and Associates <br />CITY/STATE/ZIP: Wheatland, CA 95692 <br />PHONE (1): 530-415-6623 PHONE (2):530-633-0117 FACSIMILE: -530-633-0119 <br />TENTATIVE* APPOINTMENT DATE 7/16113 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 S - $ FE OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT DATE ��at <br />Electronic Information: ❑ List ❑ Map — Description: <br />Street # <br />FILE ADDRESS <br />Street Name <br />City <br />EHD USE ONLY <br />❑ Unit 1 <br />1. <br />6750 <br />South Longe Street <br />Stockton <br />Stockton <br />H 111 <br />- <br />❑ Unit 2 <br />2. <br />7100 <br />South Longe Street <br />3. <br />7199 <br />South Longe Street <br />Stockton <br />Stockton <br />�\ <br />_ / <br />' I unit 3 <br />4. <br />7679 <br />South Longe Street <br />5. <br />1621 <br />Citation Street <br />Stockton <br />u it 4 <br />6. <br />1 1641 <br />Citation Street Al ICStockton <br />7. <br />6755 <br />Dixon St (C.E. Dixon St.) F <br />Stockton <br />Stockton <br />- <br />) < <br />L Unit 5 <br />8. <br />5000 <br />S. Airport Way <br />9. <br />1888 <br />Lockheed Court <br />Stockton <br />Stockton <br />�I-) <br />f <br />1V1 0 <br />m P tk� <br />Ej nit 6 <br />10. <br />7611 <br />S. Airport Way <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 FACIUTYIVEHICLE �, n <br />X OTHER CLEANUP SITE (NON -LOP) <br />El ABATEMENT X ASTE TIREV W {3I c y �✓ 1Ju `� <br />X UNDERGROUND TANK (MONITORING/REMOVAL)D4 El FOOD FACILITY DAIRY -7— —� <br />X ABOVEGROUND TANK v ❑ CHICKEN RANCH/ DOG KENNEL ❑ WASTEWATERTREATMENT PLANT <br />X HAZARDOUS WASTEIHAZARDOUs MATERIAQ&c7'-❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARDICHEMICAL 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-5:00PM (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) 464-0138 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 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 />7 - 70 U , (� lii l T P5 / ! 1; A, r 3 a <br />`71 . li I—11 r O i S i <br />S N <br />j I ' <br />f 914/ <br />EHD 1-11-13'. ;-Dv) 0 a D �- 0t's0o� WO -1 5.5-©2XfQqdVQ7�4?� <br />7�1�-0, 5.ee r 0- rWmP 611 (os -?b -7q lonfe ( -e- tpfc p -t) r3 <br />7/(t <br />