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REQUED <br /> SAN JOAQUINCOUN EHO LOG NUMBER <br /> ULL 3 0 2009 ENVIRONMENTAL, HEALTH UE. stockton, CA PA T <br /> ENVIRONMENT HEALTH Telephone: (209) 468600 83420 Faxst main : 209) 464-0 38 Web: v.orL d 5 <br /> PERMIT/SERVICES <br /> PUBLIC RECORDS RELEASE APPLICA 10N <br /> APPLICANT: MATT SMALLEY <br /> BUSINESSlAGENCY: DELTA <br /> ADDRESS: 724 VALLEJO WAY — — <br /> CITYISTATE2IP: SACRAMENTO <br /> PHONE(1): 916 446 3803 PHONE (2): FACSIMILE: 916 638 838E <br /> TENTATIVE`APPOINTMENT DATE- <br /> (Plgse allow 10 business data tram date 0f aPp11G(Ion sutun�ttal••Tentative onl Time, <br /> y•must be ccnfirmed) <br /> CHECK BOX TO EXPEDITE REQUEST-$1!WE(C H OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT '� DATE 12r-'',x1-C)q' <br /> Electronic information: 0 List(] Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> s <br /> treetStreet Name City <br /> N [aUn)t199 NTH STOCKTON ONT W STOCKTON FORNIA ST ❑unite <br /> STOCKTON GJRGE DRIVE LATHROP <br /> 5. 3978 HWY 99 STH p�S ' Unit <br /> STOCKTON Rn 3c; f fir) <br /> 6. fout ERrP./p <br /> 7, nit 4 <br /> 8. <br /> g, UnN 6 <br /> Specific Date Range of Information Requested: From ALL to PRESENT <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES a �. <br /> (�UNDERGROUND TANK(UST)CLEANUP SITE(LOP) [j HOUSING ABATEMENT �� <br /> []SOLID WASTE FAGLITYNEHICLE <br /> OTHER CLEANUP SITE(NOR-LOP) El FOOD FACILITY <br /> ®UNDERGROUND TANK(MONITORiNGIREMOVAL t� ❑WASTE TIRE <br /> I ❑DOG KENNEL ❑DAIRY L40 1 1 /�- <br /> INHAZARDOUS WASTE GENERATOR,4 ©CHICKEN RANCH ❑WASTEwpTER TREATMENT PLANT <br /> ®TIERED PERMITTED FACILITY p( ElMOTELMOTEL C1 PUMPER TRUCKNARDICHEMICAL TOILETS <br /> TATTOOIBODY PIERCING ❑POOUSPA . <br /> ❑ ❑LAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY <br /> ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM•5:00PM(EXCLUDING HOLIDAYS) <br /> t. List Uo to ten addresses In the space above. Select the type($)of flies from the list above by checking the appropriate <br /> bOx(es). At least one file type MUST be selected. Fax to(2091484-0139 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 VAll be processed the next business day. <br /> 2. The EHD will notify the applicant if any EHD flies exist An appointment for review will be confirmed approximately ten(1o) <br /> days after receipt of application. The files will be held for at maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A Tile that is aotiveiy being worked on by END 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 fila 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)4683425. <br /> EHD USE ONLY <br /> r <br /> d : 3 ,EHD 1846 j,*,e ) u 5 I- <br /> �1K'S : (:OQo11 3rvte'•3ZIZ �n;q� arz>ps <br /> L0001o8-f5 � Lrl3q �e: {to4it7ftnl>,/14Pea • <br />