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i 'tom-r-i��i o:�..u•r n '.� .. «. ........ <br /> SAN JOAQUIN COUNTY Q7 <br /> PUBLIC HEALTII SERVICES <br /> ENVIRONMENTAL IIEALTII DIVISION <br /> ,� JJ /PUBLIC RECORDS RELEASE APPLICATION �I <br /> APPLICANT h/r //lpryst Z l�� PHONE NO 97Y^02W <br /> ADDRESS / <br /> AGENCY NAMII HONE NO <br /> ADDRESS SfTzr SlFr.+n�Y►><6.,�D <br /> F1LII ADDRESS LMD AGENCY DDA <br /> fh3,47 <br /> �(S 1 b? E cr n h ust_ <br /> -- <br /> US (P S S• e S s <br /> 4q* 01 N ti .� r <br /> //!O R <br /> u S 7 <br /> S� <br /> 1.111S NOl7CL• IS SUBIF.CT TO TUE REQUIREMENT'S IDENTIFIED IN TIIE PUBIlC HEAl.:nl <br /> SERVICESIFNVIRONMENTAL HEA L771 DIVISION (FIID) POLICY 492-007, ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, EHD FFFS AND SERVICE CIIARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND TUB EVIDENCE CODE. <br /> I. A MAXIMUM OF TF14 (10) PREMISE ADDRESSES PER REQUEST. <br /> 2. PIIBlic FII.ESIRECORDS REVIEW ARE BY p;J Pc)I !h-lGNTOY APPOIN'TAIENTS ARE <br /> ARRANGED BY CALLING (209)468-0140. OFFICE I(OURS FOR APPOINI'PIENTS ARE SUIL'DULL•D <br /> MONDAY"IIIRU FRIDAY EXCLUDING HOUDAYS, 8:00 A.M. TO 11_:00 NOON AND 1:00 P.M. TO 4:30 <br /> P.M. <br /> 3. A PUBUC RECORDS RELEASE APPLICATION AND A NON-RLI- DAI)LI_9 DEPOSIT OF $18.00 <br /> IS REQUIRED. DEPOSITS WILL HE RETURNED 1.0 -1118 APPLICANT IF 111E FILESIRECORDS ARE <br /> NOT AVAILABLE WITHIN THB CUSTODY OF THE EHD. <br /> 4. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. THE BALANC8 OF 111E CHARGES ARE DUE AND PAYABLE 'RF IOR TO REVIEWING THE <br /> DOCUMENT(S). <br /> S. PUBLIC FILFS,RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY THE EHD STAFF AT TILE EXPENSE OF TUE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. <br /> 6. ORIGINAL PUBLIC PILEVRECORDS SHALL NOT BE REMOVED FROM THE MID PRF MtSLS. <br /> SIGNATURE OF APPLICANT DATE 1 <br /> SIONATUREOFRELEASING OFFICI DATE () <br /> FJl 00 14 (REV IV92) <br />