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amil JVl%%1VII9 %-VVl`I 1'Y <br /> 111MLIC HEALTH SERVICES <br /> ENN-sRONMFNTAL IIF,ALTII DIVISI(, <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICA <br /> N'T PIIONB NO 2U%1 -8?m <br /> ADDRESS <br /> AGENCY NAME_ d:�Tcv�lG x+12 PHONE NO <br /> ADDRESS <br /> FILB ADD-WS L— GENCY .12 <br /> n&Gjn� to <br /> TIIIS NOTICE IS SUBJECT' TO TIIB RFQI)LREMENTS IDFN-ntlP.V IN THE PUBLIC HEALTH <br /> SPRVICES/ENVIRONMENTAL HEALTH DIVISION(SHO) POLICY A92-007,ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, MD PEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> I. A MAXIMUM OF TEN (10) PREMISE ADDRESSES PER REQUEST. <br /> 2. PUBLIC FILESiRFCORDS REVIEW ARE BY APPO[NTME TN ONLY. APPOINTMENTS ARE <br /> ARRANGED BY CALLING (209)468-M-4o. 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 BH 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 FEE <br /> CItARGE. THE BALANCE OF THE CHARGES ARB DUE AND PAYABLE PRIOR TO REVIEWING THE <br /> DOCUMENT(S). <br /> S. PUBLIC FILFS/RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY TH13 EHD STAFP AT THE EXPENSE OP THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. <br /> 6. ORIGINAL PUBLIC MUNRECORDS SHALL NOT BE REMOVED FROM THE MID PREMISES. <br /> SIGNATURE OF APPLICAN DATE _ <br /> SIGNATURE OF R PLEASING OFFICIAL_.• DATE <br /> Eft 00 14 (REV 12192) <br />