Laserfiche WebLink
57 /s� <br /> SAN JOAQUIN COUNTY <br /> pUISLIC IIEALTII SERVICES <br /> ENVIRONMENTAL IIF.AL'Il! DIVISION <br /> pUBLW RECORDS RELEASE APPLICATION <br /> APPI]CANP--__ ;a'�,-- V ,E l_r1 . <br /> PHONE No <br /> — ...— <br /> ADDRFSS PHONE NO .__ — <br /> AGFNCY NAME ....... <br /> ADDRESS�- <br /> L F—,�D AGENCY VA'T�i <br /> [vim <br /> 11{15 NO"['1CC• 1S StIRItiCi' 'iU -nm RFVMIZENtt3N1'S IDENTIFIED IN TIIE PUBLIC 7iFAl:TH <br /> S11RVICFS'6NVIRONMENTAI 115AC111 DIVISION(11111))1'Ol1CY A92 007,eRDINANCB CODE OF SAN <br /> JOAQUIN COUNTY, FIID P'Er.S AND SERVICE CIIAROE RESOLU110t15, SPA"I'1 WA1"F1t CODE. <br /> tJOVERNMHNT CODE AND 11ifl UVIDENCII CODE <br /> I, A MA:{1b1UhI OFTEN (W)PILEjIISB ADDRESSES PER REQUFS!'. <br /> PUOtJC FILES/RECOI?DS RFi�/IFW ARB RY &j!E0 ifJAf'&LQC(Ill-• API't)1 Ptl'MEN?"a ARB <br /> ARRANCIID UY CALLING OPI)sbIEI*.Vl , irFlltaE IIQURS FOIt APPOINI"k1tiN'1'S ARE SCIIEDUI_BD <br /> MONDAY THRU FRIDAY EXC LUDING IIOLJDAYS, 8:W A-hl. 'PJ C::OD NOON AND 1:(q P.M. CO 4:30 <br /> 3 A PUIIUC RECORDS RELFASF API'UCAT[ON ANfi A NON-LUttNIA"' ' DL•1'OSIT ttl' Cl8.00 <br /> IS REQUIRED. <br /> DIWOSITS Pill L BE CUSCODYOF THE REFUltNED TO <br /> TIIr- API'I IC.ANC IF 11IE P[LFS/RECOPJ35 ARE <br /> NSC <br /> •nIH ABOVE IDENTIFIEr) DEPOSIT IS APPIJED 'foWARDS TIIE TOTAI- FILE REVII*'W '-EE <br /> 4.C1AR61i- THE BALANCE OI'111E CIIARGES ARE DUE AND PAYABLliKt IOR TO REVIEW!UG'DIE <br /> DOCUM-:NT(S)- <br /> 5 PU01_IC I11.F_S/R[CORDS NOT RGI URN1iD IN TIW SAME CONDCLION AS RECEIVED WILL.BE <br /> CDRRECI'ED BY THE EHD STAPP AT 111E EXPENSE OF '1116 APPLICANT. MIS ADDITIONAL <br /> SERVICE WILL BE BIIJSD To'I>.'E APPI ICANT FOR PAYMENT. <br /> 6. ORWINAL PUBLIC FILL•S'R"CORDS SitALL NO'C BE R61v10VED FRUA1'IIiE FF31D PREMISES. <br /> —---._ DATE <br /> SIGNATURE OF ApMJCAN'P <br /> SIGNATURE OF R6L•EASINO C1,: DATEFICIPX --_ ---- <br /> E11 00 14 (REV 12/92) <br />