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DATE RECEIVED 1 k ' EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY `�r r <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> - 1868 East Hazelton Avenue, Stockton, CA 95205-6232 was <br /> "Telephone: (209)468-3420 Fax: (209) 464-0138 Web:www.sjgov.org/ehd r4X--A - (40 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:David Bole BUSINESS/AGENCY:Bole and Associates <br /> ADDRESS: 104 Brock Drive CITYISTATE/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 ?Zol 1 J <br /> Electronic Information: ❑ List❑ Map–Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑Unit 1 <br /> 13. <br /> . 6750 South Longe Street 1'4 gal— v\3 I tk Stockton <br /> . 7100 South Longe Street AD � Stockton El 2 <br /> 7199 South Longe Street Stockton �] <br /> 4. 7679 South Longe Street `� t) Stockton r.d nit 3 (/(l <br /> 5. 1621 Citation Street (�U r1' Stockton <br /> 6. 1641 Citation Street U IJU. Stockton B u it 4 <br /> 7 6755 Dixon St(C.E.Dixon St.) (J CJ Stockton <br /> 8. 5000 S.Airport Way L/�� S ., L�/ Stockton ❑unit 5 <br /> 9. 1111 Lockheed Count. 10 i�✓, , Stockton ('/. I ` <br /> 10. 1 7611 S.AirportWay -C t- (iL 9�i Stockton ) �Jnit 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) ❑HOUSING ABATEMENT X AIR 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 TRUCK/YARDICHEMICAL TOILETS <br /> XTIERED PERMITTED FACILITY n POOLISPA [-ILANE)USE APPLICATION SITES <br /> F1TATTOO/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 91412 <br />