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0 <br /> -TrL <br /> SAN JOAQUIN COUN EHD Loc NUMBER <br /> Lk 3 0 2009 ENVIRONMENTAL HEALTH DE. Stockton, CA PA T <br /> ENVIRONMENT HEALTH Telephone: (209) 4 8600 83420 t=axst Main ! 209) 464-0 38 Web: �w�v;s v.or / <br /> PERMIT/SERVICES e d <br /> PUBLIC RECORDS RELEASE APPLICA ION <br /> APPLICANT: MATT SMALLEY <br /> BUSINESS/AGENCY: DELTA <br /> ADDRESS: 724 VALLEJO WAY <br /> PHONE(1): 916 446 3808 PHONE (2): CITY/STATE/ZIP: SACRAMENTO <br /> TENTAT/VE"APPOINTMENTDATE: FACSIMILE: 916 538 8385 <br /> (Please allow 10 business days From date of application submittal.• Time. <br /> Tentative only,must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$1EE(C . H OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT /0 <br /> DATE 12..--30-0q <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name <br /> --- City <br /> t1 6100 HWY 99 NTH STOCKTON— - - <br /> (a 2. 1617 FREMONT W <br /> STOCKTON }.�. , =•-6` :,r..., ;� I�'1Fii� \ <br /> (� 3. 3212 CALIFORNIA ST i•'E ❑Unit2 <br /> STOCKTON <br /> 4. 16470 CAMBRIDGE DRIVE <br /> LATHROP r <br /> 5. 3978 HWY 99 STH ^ "- I,` . `` , ' '.. .,j..: Unit <br /> _ STOCKTONtF2yi.r I°5a- <br /> e. Pio vi EQ, � <br /> 7. nit 4 <br /> 9. — Q Unit 6 <br /> i <br /> Specific Date Range of Information Requested: From ALL to PRESENT <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILETS } <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENTI h(e <br /> ❑OTHER CLEANUP SITE(NON-LOP WASTE 1 G <br /> ❑WASTSOLID WASTE FAGLITYNEHICLE <br /> ) FOOD FACILITY E TIRE I ,� <br /> ®UNDERGROUND TANK(MONITORINGIREMOVAL) A ❑DOG KENNEL ❑DAIRY t�A►i�3 <br /> ®HAZARDOUS WASTE GENERATOR,/, ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT I -(D l n <br /> TIERED PERMITTED FACILITY O(, ❑MOTEL/HOTEL <br /> ❑TATTOO/BODY PIERCING ❑PUMPER TRUCKIYARD/CHEMICAL TOILETS <br /> ❑POOUSPA LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY$:00 AM-5:00PMI (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(2091484-Q13E 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!ties exist An appointment for review will be confirmed approximately ten (1p) <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 Ale Is available. <br /> 4. Any file not returned in the same condltlon as released will be reorganized by EHD staff at the expense of the applicant. <br /> Future Ilia reviews by the same applicant may require a$115 deposit prior to review- <br /> s. If you need further assistance, please contact Diane Martinez,at(209)468-3425. <br /> END USE ONLY <br /> J' S r o.T f), <br /> 00 011- 3glZ <br /> EMD 48.06 4L4it) CD0ee j r) ;-",0/7 <br /> U files Wr0refl7,e <br /> 0108�5 GQpl3j110� � V <br /> j�ldpea <br />