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bb yy 1`J`j3 lJG;Z 1ltlm rKUI•I I u <br /> SAN JOAQUIN COUNTY �Y";f P( t <br /> PUBLIC HEALTH SERVICES � � <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> 1� Z_ <br /> APPLICANT ��C.-5�t�f r- � F PHONE NO '71/i `f� <br /> ADDRESS_ -i`, ./}� Id �c... 1 IU 4 1i I�; V/. I!` ( /) <br /> AGENCY NAME_- ( 1, , (;n, 1-.� C PHONE NO <br /> ADDRESS <br /> FILE ADDRESS LEAD AGENCY DAT <br /> <'G(rc_f UalLo•✓ TvcItTZ/'dlrgc.l,� <br /> PAY <br /> &I y <br /> - eIvEl <br /> MAR 2 8 1.4.v5 <br /> SAN JOA(1111 COU" y <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDE 0&E vtojjjav'9EALTH <br /> SERVICESIENVIRONMENTAL HEALTH DIVISION(EHD)POLICY#92-007, ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, EHD FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1. A MAXIMUM OF TEN (10) PREMISE ADDRESSES PER REQUEST. <br /> 2. PUBLIC FILES/RECORDS REVIEW ARE BY APPOINTMENT ONLY. APPOINTMENTS ARE <br /> ARRANGED BY CALLING (209)468-0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 A.M. TO 12:00 NOON AND 1:00 P.M. TO 4:30 <br /> P.M. <br /> 3. A PUBLIC RECORDS RELEASE APPLICATION AND A NON-REFUNDABLE DEPOSIT OF$78.00. . <br /> IS REQUIRED. DEPOSITS WILL BE RETURNED TO THE APPLICANT IF THE FILES/RECORDS ARE <br /> NOT AVAILABLE WITHIN THE CUSTODY OF THE EHD. <br /> 4. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FIDE <br /> CHARGE. THE BALANCE OF THE CHARGES ARE DUE AND PAYABLE PRIOR TO REVIEWING TjIE DOCUMENT(S). <br /> 5. PUBLIC PIL ESMECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY THE EHD STAFF AT THE EXPENSE OF THE APPLICANT. -THIS ADDITIONAL ' <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. <br /> 6. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> I <br /> SIGNATURE OF APPLICANT 17 7G' DATE <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14 (REV 12/92) <br /> TOTAL P.02 <br />