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APR-ZO-98 13:05 Fram: Tetra To ' San Francisco 4159745914 T-595 P.02/02 Job-88T <br /> 1 <br /> x r- <br /> t2AN JOAQUIN COUM-f <br /> I PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APP' .ICANT %A%- ct C U2.N2ivvv c q-44.i <br /> PHONE NO (`lIC `ILS) '{t'�`?�(.+�ql <br /> ADD SSS 1 wri ,S,a�c LT�Cw Frw.clSLO aYW DS Cts+ur <br /> AGE <br /> -:Cy NAME t rs^T�� -PHONE NO <br /> ADD ass - - 4� <br /> i <br /> } k}{-#i wrtf+rer+xxxxrrtetxt}*i*}#+t#++kkt+*xrk kt++r� kf t+#.t####t}# <br /> FUL� ,AQURESS BUSIN -SG NAME/ OGRAM OR <br /> FACILITY TYPfi OF F7tA <br /> LW ig-\,K E <br /> _61!t a c\ rrbs l� �sTi G IL. idi LtS, <br /> SR]N 1;1 n r�.l .. N 1 �'beiSlA �sNN dM 6�+USTir <br /> I 1 <br /> r+k#xfx*###ftx}t###t#ttftr#t+ttxf###xtt}##}*k#kr+###xrxxk}}#t+ri} <br /> THIS IOTICE IS SUBJECT TO THE REOLnREMENTS IDENTIFIED IN E PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL THHEALTH DIVISION (EHD) POLICY 194-007, ORDINANCE CODE OF <br /> SAN P0AOUIN COUNTY, EHD FEE AND SERVICE CHARGE RESOLUTIONS. STATE WATER CODE. <br /> GOVERNMENT CODE AND THE EVIDENCE CODE_ <br /> 1_ A!MAXIMUM OF TEN ILOl PREMISE ADDRESSES PER REQUEST <br /> 2. PUBLIC FILES/RECORDS REVIEW IS BY APP,gINTMENT ONLY. APPOINTMENTS ARE PROCESS- <br /> ED Bj CALLING 1209)488-3420. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> THR FRIDAY EXCLUDING HOLIDAYS, 8:00 AM TO 12:00 NOON AND 1:00 TO 4:30 PM. <br /> 3- A IIPUBLIC FILES/RECORDS RELEASE APPLICATION [PARA) IS REQUIRED, <br /> 4. Pt1BLIC FILES/RECORDS NOT RETURNED IN THE SAME. CONDITION AS RECEIVED WILL Be <br /> COREIECTEO BY THE EHD STAFF AT THE EXPENSE OF WE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. (SEE EHD POLICY 94- 007) <br /> 5. OIgIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> ..... ................... ... ......,.................. <br /> SIGN i TURE OF APPLICANT C,Cd»na DATE Y ✓✓�� Q - <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14.IREV 9198! <br />