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JRN-11-1996 13:67 FRO" GEOLOGIr_AL TECFilICS TO 4646138 P.©2 <br /> EH 00 14 (REV $104) SAN JOAQLW COUNTY <br /> PUBLIC REALM SERVICES l I n r I� <br /> ENYIRONA�d MAL HEALTH DMSION l <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPJ'IC4lgT G Ecx0(,V.i+%-- TetH.aics tom- PHONE NOS j 3S'- 6,yx'! <br /> ADDIMSS ei Dc, :j,n — <br /> AGENCY b]1UvL6 PHONIi NO <br /> ADl?MS ' <br /> (ALL IEA) <br /> "J E�<AL.on1 CR) DATE <br /> 11`7 STAI.IiISLAV$.SIRL`i`r _ v3'C—AHS-Eyb '- <br /> ��/3 �. rn5�.M r T1c'n"[Jh/E • .. r/ - --"/�i., _ �I <br /> r. <br /> /•ID$criovrf•t-tic kcy,Q.� /-?vC�t�1� v !r rr •� is F <br /> /1416 fOr;4, fLw Ay"Ze <br /> /70]. Aek!,c,J - U - <br /> i I <br /> 7HI3 NOM IS SUB15CI' To THE REQUIREMENTS IDSN77FIED IN TIM PUBLIC HEALTH <br /> SERVIC RONMHNTALHEALTH DIVISION (EHD)POLICY k44-007, ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, 9RD FEES AND SERVICE CHABl3H RESOLUTIONS, STATE WATER CODE, <br /> COVERNMENt CODB AND THE EVIDENCE CODE. <br /> { <br /> 1. A M"AiUM OP TEN (10)PREmiBE ADDpMgES PFR REQUEST. <br /> 1 <br /> 2. PUS FILEWRECORDS REvIHw n BY APPOINTMENT pNt,Y. AppotxrMSNn,tRa ARRANOsn is <br /> CALLINO (20"-0340L OFFICE ROUM FOR APPOROIt MM ARE SCHEDULED MONDAY THRU ftIDAY <br /> EXCLUDING HOLIDAYS, 6:00 AM To 12:00 NOON AND 1:00 Pm To 4:30 PAL <br /> I <br /> 3. A PUBlhC RBCOPM RELSAM APPLICATION(PRRA) IS R2QUniFD. <br /> 4, PU*UC, iLF3lRECORDS NOT RQrURNED IN TNB SAME CONDrrION AS F&cErr lI wjLL BE CORItECrm <br /> BY THE'EHD 37AFF AT THE MENSE OF THE APMICANT. THn ADurnONAL SERVICE VFH.L BE BILLED TO THL <br /> APKXIANT FOR PAYMENT. (SFS EHD POLICY 94407) <br /> s• amwiL PUBLIC FILES/RECORDS BHALL liar B6 RFA40VED i•ROM TRE EHD PREMISES. <br /> SIGNATURE 00 APPLICANT��1��_ DATE S II <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> No PUSIEREg Rsc-=D /FB.B ARE roBNT>FtsD: <br /> re,vrnar,o,— <br /> PHS/F.HD RstoRWFLIIN WMr ON THA AEwxz Bs) NOr®. YOU Y4itt.1iB NOTIFIPD WHEN <br /> RECORDS/FILEB ARB AVAILABLE FOR RBVIMW: <br /> °^� ., <br /> Mwnglfor M.z <br /> 1 j 1. , , i i . r I. � 11 I I Hl H'.I•f� <br /> I l <br />