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DATE RECEIVEDSAN .1OAQUIN COUN J ILI <br /> Copy EHD LOG NUMBER <br /> � ,7 � '�� P000 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> L <br /> - 1$66 East Hazelton Avenue, Stockton, GA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209) 464-0138 Web:www.sjgov.org/ehd <br /> d�l` <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 Z/ot 1 - <br /> Electronic Information: ❑List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name city ❑Unit 1 <br /> F3. <br /> 6750 I South Longe Street 04 c-t_ V", I Stockton <br /> 7100 South Lange Street AD Stockton 0 Unit 2 <br /> 7199 South Longe Street (�U �� Stockton <br /> 4. 17679 South Longe Street (.l Stockton Unit 3 I�(4 <br /> 5. 1621 Citation Street nJ Stockton <br /> 6. 1641 Citation Street Stockton 0 Unit 4 <br /> (�V <br /> 7 6755 Dixon St(C.E.Dixon St.) (�v Stockton <br /> 8. 5000 S.Airport Way 6) 511k,_,, U 1� Stockton 0 Unit 5 <br /> 9, 1888 Lockheed Court ,4 d I� Stockton <br /> 10. ' 7611 S.Airport Way C f L�i Stockton ) CP0'6'jt 6 <br /> 11 <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) Q MEDICAL WASTE FACILITY X LID WASTE FACILITYIVEHICLE <br /> X OTHER CLEANUP SITE(NON-LOP) ❑HOUSING ABATEMENT X ASTE TIRE <br /> X UNDERGROUND TANK(MONITORINGIREMOVAL) ❑FOOD FACILITY DAIRY <br /> XABOVEGROUND TANK ❑CHICKEN RANCH/DOG KENNEL ❑WASTEWATER TREATMENT PLANT <br /> X HAZARDOUS WASTEIHAZARDOUS MATERIALS ❑MOTELIHOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> X TIERED PERMITTED FACILITY POOLISPA ❑LAND USE APPLICATION SITES <br /> TATTOOIBODY PIERCING ( X ROMPLAINTIRESPONSE 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 /> 0 Records provided by Staff-PPR Complete. Staff Name: <br /> EHD 48-06 9/4/12 <br />