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SAN ,JOAQUIN COUNTY EHD LOG NUNIBCR <br /> Utt 3 0 2009 ENVIRONMENTAL, HEALTH DEPARTMENT <br /> 600 Est Main S . Stocktun, CA <br /> ENVIRONMENT HEALTH Telephone: (209) 46883420 Faxt (209) 464-0138 Web:3029 www.sjgov.org/e d3� <br /> PERfdIIT/SERVICES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: MATT SMALLEY <br /> BUSINESS/AGENCY: DELTA <br /> ADDRESS, 724 VALLE.70 WAY <br /> CITY/STATE/?IP: SACRAMENTO <br /> PHONE(1)7 916 446 3803 PHONE (2): <br /> TENTATIVE`APPOINTMENT DATE- FACSIMILE; 916 638 8385 <br /> (Please allow 10 business days from date of a Tt be. <br /> application submittal.'Tentative only.must be canfirmad) <br /> ❑CHECK BOA TO LICA TE REQUEST $115h'EE(C�p$H OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT_ � ' '�LL� DATE I2_-3L)-0q <br /> Electronic Information: [] List Ej Map-Description: <br /> FILE ADDRESS END USE ONLY <br /> Street# Street Name <br /> — - ...--- city <br /> --_._ �._._. <br /> 1. 610 0 _—_. -- — --- <br /> HWY 99 NTH STOCKTON <br /> 2. 1617 FREMONT W STOCKTON \ <br /> 3• 3212 CALIFORNIA STSTOCKTON — ❑Unit2 <br /> 4. 16470 CAMBRIDGE DRIVE LATHROP \ <br /> 5. 3978 HWY 99 STH \ <br /> STOCKTON rF.IFC <br /> G. <br /> 7. <br /> 8. <br /> 9. Unit 8 <br /> Specific Date Range of Information Requested: From ALL <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES to PRESENT <br /> ®UNDEROROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT <br /> Q SOLID WASTE FAGLITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) <br /> ❑FOOD FACILITY F1 WASTE TIRE <br /> ®UNDERGROUND TANK(MONITORINGIREMOVAL) ❑DoG KENNEL ©DAIRY <br /> ®HAZARDOUS WASTE GENERATOR ©CHICKEN RANCH <br /> ®TIERED PERMITTED FACILITY O WASTEWATER TREATMENT PLANT <br /> ❑TATTOO/SODY PIERCING 0 MOTBUHOTEL ❑PUMPER E APPLICATION SITES TOILETS <br /> OTHER(P ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OYHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM- <br /> 5:00PM(EACLUDING HOLIDAYS) <br /> 1. List uo to On addresses In the space above. Select the types)of files from the list above b checking the appropriate <br /> ;0x(11). At least one file Y gabove. <br /> Address type MUST be selected. Flax to(2081 484-0138 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 appolntmentfor review will be confirmed approximately ten (10) <br /> days atter 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 Tile 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 or the applicant. <br /> Future file reviews by the same applicant may require a$115 deposit prior to review. <br /> 5. If you need further assistance,please contact Diane Martinez,at(209)468.3425. <br /> EHD USE ONLY <br /> EMD to-OB <br /> efSb09 <br />