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114, ..� 11; ID4 t l r H5bU1..1 H l t:D NU. li lel t�J <br />12-14-1994 11104PM FROM TO 191632548 <br />• SAN OAQUIN COUNTY • t EII C3Q I4 (jtEv5194) 1 �-�I'UBIAC IfF.ALTLI SERVICES <br />�vIRc)NmENTAL IiEALTH i MSION - s <br />FUgLIC RECC)"S RELEA6E A,MACATiUN 3 <br />APPLIC T. kka 0,—, ONE NO'! ) - 3Z <br />ADDRESS I Gil <br />A <br />FILIi ADDiE�S5 LF..A�� �� <br />a -�- <br />a <br />- l <br />THIS NOTICE 15 StJWkCT 'TO TAE REOUIki MENT5 ID$47IFTBD IN THE PU811C HEALTH <br />SERVIC SMMVIRONMWTAL ASALTH DIYIS1ON (WD) POLICY 994-047, ORDINANCII CODE OF SAN <br />1OAQUIN COUNTY, alD FFLS ANb SERYIcE CNARCH RESOLUTIONS, STATE WATER CODE. <br />GQvRRj4MFf4T CoDt AND VE EVIDENCE CODS. <br />L A MAXWVM Of ItN (I®) PREMIss A"RWSES rMt REQUEST. <br />2. PtJB VILESIRECORIiS Rj3VItW M 9Y A APPCJIRMOI'i3 AU ARRANOW BT <br />CALLING (W9)469-oJ40. or -FIC -S itot= FSR APP[ jKjjlEMs AR$ SCHEDULED MONDAY T*RU tWDAY <br />;. <br />EXCLUDIN0 140iibAYS, 8;W AM too 12:0V NooN ANb 1,00 mi 'too 4„30 PM. <br />`s�. 3. A PLmuc REccabs RELWs APP=A2mN (PRRA) ss XE00-Eu- <br />4 <br />QIJR(.!C rILIMAhCORDS Ngr RBIt1:ENED IN TtW SAMr, CMDiiloii AS RE'CENRD WILL BE CORAUCTED <br />SY litt till) STAt* AT tHo SXM*ftB OV M APt1.1CAim TIi13 ADDii7ONAL zERVICP WILL 8B MUD TO THE <br />AeUCANT PM PAYMt"T. (S8B EHD POMP 9d-�Ot37) <br />5. Oti 04AL Mm Plils%ECORDs 30AI-L NOT to ke*YVED FIt m 1 -ma Ei{D PPM4131Z. <br />SI(7NATUItE op .APPLICANT DATE <br />SIGNATURE OF KPA,p.AS[Nd OFFICIAL GATE <br />NQ PNSfEkD 1ZCbkWJPlLM A” IbWMFIHUt <br />p„n, �as..a rn �anna*+cs, waw <br />i <br />PHS/�#f31t1;caitna/1fi_ss sxtrr v�ITlje AbOdr�(� tYvrxn. 'Yfli? �nt,L as r�v7i�1� vvstaia <br />TOTAL P.02 <br />