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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES 3 V 7 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> r PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT Shll ltr ALIyer PHONE NOq�2A <br /> ADDRWS ' <br /> AGENCY NAME PHONE NO <br /> ADDRESS i t9 k-3 V 110't sl1 - r <br /> FILIi ADDRESS LEAD AGENCY pA� <br /> ,3003 E llanrmer` Lr? rJ�� <br /> r� rwv - <br /> 3aU3IZ <br /> 52Ta 'L7-9 Ami kr oral 5 2 2 <br /> + 2i�/I i•{VC� fM SPX orf lJ 'L-�1c�'2? "". .`Z. <br /> 3� Rat�y Ce►�cr ' D�S�•fon 95�z <br /> 77HS NOTICH IS SUBJECT 'I.O 'IEE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTALHEALTH DIVISION(RHD)POLICY#92-0OW,ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, SM FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1. A MAXIMUM OF TEN (10)PRHMISH ADDRESSES PER REQUEST. <br /> 2. PUBLIC FILEWXCOIIDS REVIEW ARE BY APPOINTMENT ONLY, APPOINTMENTS ARE <br /> ARRANGED BY CAL11NO (209)468-0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 A_IvL 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 578.00 <br /> IS REQUIRED. DEPOSTI•S WILL BE RETURNED TO THE APPLICANT IF TILE Fpy"2CORDS ARE <br /> NOT AVAILABLE WITHIN THE CUSWDY OF THE MID. \ <br /> 4. THII ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS 114E TOTAL FILE RBVFEW FEE <br /> CHARGE. THE BALANCE OP.THE CHARGES ARE DUE AND PAYABLE FBLQ$TO REVIEWING THE <br /> DOCUMENT(S). <br /> 5. PUBLIC FIL.ESI"CORDS NOT RETUP-14ED IN THE SAME CONDITION AS RECEIVED WILL 86 <br /> CORRECTED BY THE EM STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL BE BILLED TQ TIM APPLICANT FOR PAYMENT. <br /> 6. ORIGINAL PUBLIC FII E&MCORDS WALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> SIGNATURE OF APPLICANT • DATE / H <br /> 9IGNATURBOFRFJRASING CIAL DAT13 <br /> EH 00 14(REV 12142) <br />