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TO G 4640138 P.02,�^ <br /> I'If1Y-89-1995 15= 11 FR/ $F,GEOLOGICPL TEG-PACS 4 � .,x�a�e r.•r1G Y ' �n <br /> ER 00 14 (REV .5194 SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> 3ENMEN <br /> VIKONTAL IIEALm DI,YISIoN <br /> PUBLIC RECOFMS RELEASE APPLICATION <br /> APPISCAN-r 52 ��/ yG� ONE NO <br /> ADDRESS Fes: 7Gf/ /✓ /. /" sic <br /> AGENCY NAME PHONE NO <br /> ADDRESS r�iL ��4 acs <br /> FILE ADD WS LFAI) AGBNCY <br /> 7- 4,/, fl-7 <br /> ^ ' '� -ZL_._ <br /> r. � <br /> 14, <br /> 731-1 oz5aizc <br /> ��gl��MrT �, STk �f_7e2-,..�s � ..1�r- A...Trr •• <br /> I <br /> i <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE ?UEuc HEALTH <br /> SERVICESTNVJRONMENTALHFIILTH DIVIS[ON(PHD)POCKY 444-007. ORDINANCE--ODE OF SAN <br /> JOAQUIN COUNTY, ERE) FEES AND SERVICE CHARGE ROOLU11ONS, STATE WATER CODE, <br /> GOVFRNMT NT CODE AND THE EVIDENCE CODE. <br /> 1. A MAaMUM OF TEN (10) PPOAME AVMESM PER REQUNST. <br /> Z ?VeuC'FM2&%EC0RDS REVIEW m sY 4, PPOINT{1LFI T oux. ArrourlMPM ARE ARRANGED BY <br /> CALLING (299)488-034Q OPME KOU" POR APMU"MENTS ARE 3C411DULED MONDAY TRAU FRIDAY <br /> EXCLUDING HOLIDAYS, 8:00 AM To 17,100 NOGN AND 1:00 PM m 4:30 PAA. <br /> 3. A FUBM RBCORM ROZA=APPUCATION(PRRA) Is REQUmw.' <br /> 1. PUeuc'PILHS4MC0RDS 407 RHLURNED IN THE LAME =4011IOM AS RECEIVED WILL SE GOMMCTED <br /> SY TRE'EHD,TTAFP AT-MR M39ME OF =9 APPMANT. THIS ADDMONAL SFRVICS ID I=. SS SII I rn TO THE <br /> APPLtiANT POR .'ATMFMT. (S86 EHD FoucT 94-aM <br /> 5. OP-14"AL L PUBLIC F11.2&M.HCORDS SHALL,Par 39 REMov6D FROM Tar EHD PRwKmm <br /> SIGNATURE OF APPLICANT DATE <br /> SiGNATVRE OF RELEASING OFFICIAL DATE <br /> No PHSIERI7 Rn=RDSIFmm ARs IDENTwm- <br /> bni. -- �b.,or m no,mra.,n.,u.► <br /> PHSIEM R TMWFa.ra 0413t oN THE Amvx*ss) 4OrED. You wmL im Nour m WHET( <br /> RkCORSSIF= ARE AVAILARIE FOR RCVMW: <br /> TOTAL F-02 <br />