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Ell UU 14 (HEV 5/94) SAN JOAQUIN COUNTY ,� <br />MR1,1C HEALTH SERVICIsSy <br />I"MMONMENTAL HEALTH 1)171S'ION <br />PUBLIC ILECORDS ItENA" ASE A111'LICATION <br />APPLICANT b,4(_E�i4L,,, /5/, -c -(t PHONE NOS 33 If -aG/ 7`-�v <br />ADDRESS -(2 A-�/Vy (f-4 c?S2 7- <br />AGENCY <br />AGENCY NAME PRONE NO <br />ADDRESS <br />FILE ADDIUSS LEAD AGENCY DATE <br />/Lc- <br />L O P <br />3'ae'cc ? 5 - <br />THIS <br />TTIIS NOTICE IS SUIIJECP TO THE REQUIREMENTS IDENTIFIED IN TIIE PUBLIC IIEALTII <br />SERVICES/ENVIRONMENTA LIIEALTII DIVISION (EIID) POLICY 1194-007, ORDINANCE CODE OF SAN <br />JOAQUIN COUNTY, E11D FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br />GOVERNMENT CODE AND IIIE EVIDENCE CODE. <br />A MAXIMUM Or'rrN (10) PREMISE ADDRESSES PER REQUC.4r. <br />2. PDnuc FILES/RECORDS REVIEW Is nY APPOINTMENT ONLY. APPOINTMENTS ARE ARRANGED BY <br />CALLING (209)468-0340. OrmcE IIouRS FOR APPOINTMENTS ARE SCIIEDULCD MONDAY TIIRU FRIDAY <br />EXCLUDING HOLIDAYS, 8:00 AM To 12:00 NOON AND 1:00 rM To 4:30 PM. <br />3. A Puuuc RECORDS RELC•ASE APPLICATION (PRRA) S REQUIRED. <br />4. Punuc FILES/RECORDS NO"r RGrURNCD IN TIIE SAME CONDrr1ON AS RCCrIVED WILL 0L' CORRI!CriiD <br />0Y THE EI -ID STAFF AT THE nXPENSE OF THE APPLICANT. THIS ADDmoNAL SERVICE WILL HE BILLED TO THE <br />APPLICANT FOR PAYMENT. (SEE EIID POLICY 94-007) <br />5. ORIGINAL Punic FILES/R!a?S SIIALL NOT BE REMOVED FROM TIIE E11D PREMISES. <br />SIGNATURE OF APPLICAN'1�( c 11p •�u �� DATE </ z (o '9 <br />SIGNATURE OF RELEASING OITIC1AL DATE- <br />No <br />ATE <br />No PIIS/EIID REcoaus/Fn.r_9 ARE IDEN"FIFfCV: <br />bun. Pm,mvnn m Wnn+unr.r be m: <br />ITIS/E111) RECORDS/17ILF-9 r -KIST ON Till! ADURCSS(E.9) Norm. YOU WILL HE NOrIFIED wurr.N <br />IiFI:URUS/17O.RS ARF. AVAILAnLF FOR Itr.VIF.W: <br />Mm N'm ..r. Hmrn•emw bsu: <br />