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1iD rG NUMBER <br /> DATE RECEIVED SAN JOAQUIN COUNTY <br /> �Cjk -7/-1 /0 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Q yv 'Telephone: (209)468-3420 Fax: (209) 464-0138 Web:www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: David Bole BUSINESS/AGENCY:Bole and Associates <br /> ADDRESS: 104 Brock Drive 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: 7116113 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 A OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT 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 i'41- vo T— t Stockton <br /> 2. 7100 South Longe Street 140 Stockton [I Unit 2 <br /> 3. 7199 South Longe Street (�0 �� Stockton <br /> 4. 7679 South Longe Street plu Stockton -- Unit 3 17/11t <br /> 5. 1621 Citation Street Stockton <br /> 6. 1641 Citation Street fJ� Stockton ®u it 4 (0/ -\ <br /> 7 6755 Dixon St(C.E.Dixon St.) Stockton X v) <br /> 8. 5000 S.Airport Way L 1 11 -ft., U Stockton ❑unit 5 <br /> 9. 1888 Lockheed Court 14 d i� , Stockton <br /> 10. 11 7611 S.Airport Way P-C f LV' ,` Stockton <br /> nit 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 X LID WASTE FACILITYIVEHICLE <br /> X OTHER CLEANUP SITE(NON-LOP) [I HOUSING ABATEMENT X ASTE TIRE <br /> X UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY DAIRY <br /> X ABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> X HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> XTIERED PERMITTED FACILITY �POOLISPA El LAND USE APPLICATION SITES <br /> ❑TATTOO/BODY 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 /> ❑ Records provided by Staff-PPR Complete. Staff Name: <br /> EHD 48-06 914112 <br />