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- - - — - - - -C,elu_y01- <br /> 7" Aa� <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> PHONE NO aOC/ y 77-3ev0 <br /> APPLICANTjr <br /> ADDRESS 7-7 � � !Cello �� �� PHONE NO N <br /> AGENCY NAME <br /> ADDRESS <br /> +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ <br /> BUSINESS NAME/ PROGRAM OR <br /> FULLNESS FACILITY TYPE�LE <br /> r n 7dtACy AP r7F,l3EdZ USr — Je,t <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION (EHD) POLICY 1194-007, ORDINANCE CODE OF <br /> SAN JOAQUIN COUNTY, EHD FEE 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 IS BY APPOINTMENT ONLY. APPOINTMENTS ARE PROCESS- <br /> ED BY CALLING <br /> RE <br /> THRU FRIDAY EXCLUDING 13RAPPOINTMENTS <br /> HOLIDAYS, 8 00 AM TO12:00 NOONAND 1:00 TO 40-.30 PMMONDAY <br /> 3. A PUBLIC FILESIRECORDS RELEASE APPLICATION (PRRA) IS REQUIRED. <br /> 4. PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> NSE OF THE APLICANT. THIS ADDITIONAL <br /> CORRECTED <br /> CE WILL BE BILLED TO THE A Y THE EHD STAFF AT TH ANTE OR PAYM NTP SEE EHD POLICY 94- 007) <br /> 5. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM.THE EHD PREMISES. <br /> aarararrar♦aaraarrarrr rear♦ r+ar era rra rarrasaarr aara +=)-)a• araar <br /> �'1�� ♦rr <br /> SIGNATURE OF APPLICANT " <br /> i DATE <br /> - DATE <br /> SIGNATURE OF RELEASING OFFICIAL_ <br /> EH'00 14 (REV 91961 <br />