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7�LJ <br /> SAN JOAQUIN COUN EHD LOG NUMBER <br /> 209 ENVIRONMENTAL, HEALTH DEPA T <br /> 955202- <br /> ENVIRONMENT MENTHEALTH Telephone: (209) 468-3420 Fax600 East Main . (209) 464-0 38 Web: `'w�,V;s v.org/e g/e d <br /> PUBLIC RECORDS RELEASE APPLICA ION <br /> APPLICANT: MATT SMALLEY <br /> BUSINESS/AGENCY: DELTA <br /> ADDRESS: 724 VALLE,70 WAY <br /> PHONE(1): 916 446 3803 PHONE (2): CITYISTATE/ZIP: SACRAMENTO <br /> TENTAT/VE"APPOINTMENTDATE: FACSIMILE; 916 638 8385 <br /> (Please allow 10 business days from date of a Time: <br /> pplication submittal.'Tentative only•must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$11 EE(C H OR CHECK ONLY)-REQUEST F ROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT /-A <br /> DATE <br /> Electronic Information: List[] Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name <br /> _----... -------._• _ City <br /> i 1. 610 0 [�Unit <br /> HWY 99 NTH 1 <br /> STOCKTON _- 1 r''�'� -. � __0> ` \U <br /> V/ (a 2. 1617 FREMONT W STOCKTON �r/r: \ <br /> (p 3. 3 212 CAI .IL tee NIA STN STOCKTO ❑Unit 2 r 1 <br /> fvV t`< t <br /> Cj 4. 16470 CAMBRIDGE DRIVE LAT14ROP - <br /> /'-` Unit <br /> 5. 3978 HWY 99 STH w j. STOCKTON <br /> 6. Pio u;I ERr�� <br /> 7• - - nit 4 <br /> 8. <br /> 9 ❑Unik 6 <br /> Specific Date kange of information Requested: From ALL to PRESENT <br /> ENVIRONMENTA(,HEALTH DEPARTMENT-FILES - <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT -W I h <br /> ❑OTHER CLEANUP SITE(NON•LOP) ❑FOOD F ❑SOLID WASTE FACILITYNEHICLE <br /> FACILITY ❑WASTE TIRE® ,„UNDERGROUND TANK(MONITORINGIREMOVAL) f� ❑000 KENNEL ❑DL4fi f�� <br /> AIRY /- <br /> ®HAZARDOUS WASTE GENERATOR, ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> ®TIERED PERMITTED FACILITY p(, ❑MOTEL/HOTEL ❑PUMPER TRUCK/YARD/CHEMICAL TOILETS <br /> ❑TATTOO/BODY PIERCING ❑POOLISPA <br /> [I MEDICAL WASTE FACILITY El LAND USE APPLICATION SITES <br /> ❑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 D13E 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 w111 be processed the next business day. <br /> 2. The EHD will notify the applicant If any EHD flies exist An appointment for revlew will be confirmed approximately ten (1o) <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 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 Ale is available. <br /> 4. Any flle not returned in the same condition as released will be reorganized by END staff at the expense of the applicant, <br /> Future flte reviews by the same applicant may require a$115 deposit prior to review. <br /> 6. If you need further assistance, please contact Diane Martinez,at(209)468-3426. <br /> EHD USE ONLY <br /> 0, S r o/,f <br /> b Coal <br /> q JZ <br /> EHD 48-06 e u 5 3 t? \11 ;-';on <br /> files : c0(�II 31o�re'.3 ZIZ�ily��,Q� � an�,o9 <br /> Cc00108-f5 (pppl311 ((re: 10q-f0 Ail Idpe) <br />