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41 <br />SANJOAQUIN <br />—COUNTY -- <br />Greatness grows her <br />APPLICANT: DAVID BOLE <br />ADDRESS: 6898 PENNY WAY <br />RECEIVEovironmental Health Department <br />PlAY 16 2018 <br />zNVIRONMENTAL HEI <br />PUBLIC RECORDS RELEASE APPLICATION <br />EHD LOG NUMBER: 88795 <br />BUSINESS/AGENCY: BOLE & ASSOCIATES <br />CITY/STATE/ZIP: BROWNS VALLEY, CA 95918 <br />PHONE (1): 530-415-6623 PHONE (2): 530-743-7093 FAX OR E-MAIL: DAVIDBOLE@YAHOO.COM <br />Please allow 10 business days from date of application submittal for the records to be available. <br />Staff will contact you to arrange an appointment date and time to review the requested records. <br />SIGNATURE OF APPLICANT PROCESSED VIA EMAIL BY STAFF. DOM M DATE MAY 16, 2018 <br />1. List up to ten addresses in the space below. Address ranges WILL NOT be accepted. Select the type(s) of files from the <br />list below by checking the appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-0138, mail to the <br />address indicated below, or email to info(d)sicehd.com. Applications received after 3:00 pm will be processed the next <br />business day. <br />2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted below. <br />3. 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 />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 $152 deposit prior to review. <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY -FRIDAY 8:00 AM-5:OOPM (EXCLUDING HOLIDAYS) <br />Electronic Information: ❑ List ❑ Map – Description: <br />Specific Date Range of Information Requested: From to <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />FILES <br />ponly, <br />( S ecific addresses <br />FILE ADDRESS <br />address ranges will not <br />9 <br />be accepted) <br />p ) <br />4-" tv17-74 r <br />EHD USE ONLY <br />❑ Underground Tank (UST) <br />Street # <br />Street Name <br />City <br />Cleanup Site (LOP) <br />Other Cleanup Site (Non -LOP) <br />2303 <br />WEST LN <br />STOCKTON <br />W l+M t PaST, ('Or ❑ CONSUMER <br />® Hazardous Waste <br />DAIRY <br />® Tiered Permitted Facility <br />2 <br />HM, HW, AST, CO <br />® Aboveground Tank <br />PWS <br />UST (Monitoring / Removal) <br />® Hazardous Materials <br />S <br />® Spill / Release Response <br />F1 Solid Waste Facility / Vehicle <br />4 <br />E] WATER QUALITY <br />Food Facility <br />SITE MITIGATION <br />Pool / Spa <br />Dairy <br />5 <br />Land Use Application Sites <br />Septic Pumper Truck /6 <br />❑ HOUSING <br />Yard / Chemical Toilets <br />❑ Wastewater Treatment Plant <br />® CUPA <br />Housing Abatement <br />7 <br />AST/ HM / HW <br />Motel/Hotel <br />8 <br />❑ CUPA <br />UST <br />Chicken Ranch / Dog Kennel <br />Medical Waste Facility <br />❑ Tattoo/Body Piercing <br />❑ SOLID WASTE <br />Waste Tire <br />y <br />® Complaint <br />❑ ACCOUNTING <br />E] Other (Please Specify): <br />10 <br />*""BOXED AREA - EHD USE ONLY"" <br />6/2018 -APPLICANT NEEDS PREVIOUSLY CANCELED REQUEST FOR CUPA HM FILES. GENERATED NEW PRRA AND <br />INFORMED THEM OF THE DELAY. DOM M wiz-Lite—ewnpaint #S rpoce2,s34 s com5ogLy cArQ-, <br />in *V flW F 2303 West kn <br />❑ Records provided by Staff -PPR Complete. staff Name: 4;f, EHD 48-06 <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />