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flop, �rDD <br /> SAN JOAQUIN COON EHD LOG NUMBER <br /> Li <br /> `L 3 0 2009 ENVIRONMENTAL, HEALTH DEPA <br /> 600 East Main St. Stockton, CA 95202- T <br /> ErdVIROC�R� (VTHEALTH Telephone: (209) 468-3420 Fax: (2pg� 464-0138 Web: `w;va v.or /e d <br /> PERMIT/0"ERVICES 9 q3 <br /> PUBLIC RECORDS RELEASE APPLICA ION <br /> APPLICANT: MATT SMALLEY <br /> BUSINESS/AGENCY: DELTA <br /> ADDRESS: 724 VALLEJO WAY <br /> PHONE(1): 916 446 3803 PHONE (2): CITY/STATE/ZIP: SACRAMENTO <br /> TENTAT/VE'APPOINTMENT DATE: <br /> FACSIMILE: 916 638 8385 <br /> (Please allow 10 business days from date or application submittal.• Time. <br /> Tenrafive only•musI be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-s1EE(C . H OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT / <br /> DATE <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street Street Name <br /> City <br /> Unit 1 <br /> i� 1. 6100 HWY 99 NTHSTOCKTON <br /> �j tv 2. 1617 FREMONT W STOCKTON <br /> (� 3. 3212CAI,IEORNIA ST ❑Unit2 <br /> STOCKTON <br /> �J 4. 16470 CAMBRIDGE DRIVE LATHROPr <br /> 0 5. 3978 HWY 99 STH _ Unit <br /> STOCKTON ,•7 .` '; 3r <br /> 6. u+ <br /> EQrd� <br /> 7. nit 4 <br /> 8. <br /> 9• - — _ ❑Unit 6 <br /> Specific Date flange or Information Requested: From ALL to PRESENT <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK`UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT I h'ej <br /> ❑OTHER CLEANUP SITE NON-LOP ❑SOLID WASTE FACILITYIVEHICLE <br /> ❑FOOD FACILITY ❑WASTE TIRE <br /> ® (MONITORING/REM '' II�„, <br /> UNDERGROUND TANK OVAL) A- ❑DOa KENNEL ❑DLW <br /> AIRY <br /> � El <br /> ®HAZARDOUS WASTE GENERATOR&L <br /> El RANCH ❑WASTEWATER TREATMENT PLANT <br /> W TIERED PERMITTED FACILITY pMOTEIHOTEL <br /> []TATTOO/BODY PIERCING ❑PUMPER TRUCKNARD/CHEMICAL TOILETS <br /> ❑ <br /> ElPOOLISPA ❑LAND USE APPLICATION SITES MEDICAL WASTE FACILITY ❑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($)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(2091464-0134 or mail to the address Indicated above Address <br /> ranges will not be accepted -for additional assistance with file addresses,contact the END. 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 fife 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)468.3426. <br /> EHD USE ONLY <br /> EHO 48.08 vn G i n 1'y e <br /> (-00 0)) 31o (e'•3 ZI Z �ir7iq� <br /> I:oOo 108 5 <br /> cow 3 re: lmy�0t nd� <br />