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POD <br /> W- 4WED <br /> SAN JOAQUIN COUN EHD LOG NUMBER <br /> �` , 3 Q 2009 ENVIRONMENTAL, HEALTH DrDA T <br /> 600 <br /> E[dVIROC�C��c(`�T HEALTH Telephone: (209) 468-3420 Faxst Main : 209) 464-0 38 Weockton, CA b: %wV,k or /e d-PERMIT/SERVICES 9 q,3PUBLIC RECORDS RELEASE APPLICA <br /> APPLICANT: MATT SMALLEY <br /> BUSINESS/AGENCY: DELTA <br /> ADDRESS: 724 VALLEJO WAY <br /> PHONE(1): 916 446 3803 <br /> CITY/STATE/ZIP; SACRAMEN'T'O <br /> PHQNE (2): <br /> TENTAT/VE*APPOINTMENT(DATE: FACSIMILE: 916 638 8385 <br /> (Please allow 10 business days from date of application submittal.•Tentat/ve onl Time: <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$1 EE(C , H OR CHECK ONLY) y'must be confirmed) <br /> ? Y)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT � <br /> DATE 12----_Iij G) <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name <br /> ------ _ ,. City <br /> 6100 _ _ <br /> _ Unit 1 <br /> HWY 99 NTH STOCKTON _. ., ISS ^•� '..� �/--- -- <br /> �a 2. 1617 FREMONT W STOCKTON \ <br /> !:ORNIA ST R111 <br /> (~ E3nit 2 <br /> (� 3, 3212 CALISTOCKTON te` <br /> Gj 4. 16470 CAMBRIDGE DRIVE LAT14ROP <br /> 5. 3978i ,'' U >- ,'� Unit <br /> HWY 99 STH w STOCKTON A a6. . ° <br /> Pio u+ ER, � <br /> 7. ---�-�- nit 4 <br /> 9. - — p Unit 6 <br /> Specific Date Range of Information Requested: From ALL to PRESENT <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES __ <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) El HOUSING ABATEMENT ❑SOLID WASTE FACILITNY1 I h le✓ <br /> ❑OTHER CLEANUP SITE(NON-LOP <br /> ❑FOOD FACILITY ❑WASTE TIRE EHICLE <br /> ' I„ f� <br /> ®UNDERGROUND TANK(MONITORINGIREMOVAL) 1, El DOG KENNEL �DI <br /> R <br /> ®HAZARDOUS WASTE GENERATOE]CHICKEN RANCH Q AIRY t4.II <br /> WASTEWATER TREATMENT PLANT <br /> ®TIERED PERMITTED FACILITY MOTELIHOTEL <br /> ❑TATTOO/BODY PIERCING ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑ <br /> ❑POOLISPA El LAND USE APPLICATION SITES MEDICAL WASTE FACILITY <br /> E10 THEIR(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM (EXCLUDING HOLIDAYS) <br /> 1. List up to tan addresses In the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(2Dg)464 Q73$or mail to the address Indicated above Address <br /> ranges will not be accepted -for additional assistance with file addresses,contact the EHD. Appllcations 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(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 file that is actively being worked on by EHD staff may not be Immediately avallable 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 file 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 /> 5 <br /> r 94 f_. <br /> 00 d 3 b <br /> EHa ae-os e `n <br /> i/t PUS files : 000)) //7i4> <br /> COOO108 5 ca�pj3u�i3 re: 149gVCVM�(I41#e P15 <br />