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SAN JOAQUIN COUNTY � /3 S <br /> PUBLIC HEALTH SERVICES <br /> ENVIRON11MUAL HEALTH DIVISION <br /> PUBLIC RECORDS RF.I.RASE APPLICATION <br /> AFFUCANT s CI Iv Alo l ver MONS N0250 n2lo+ <br /> ADDRBM <br /> AGENCY NAME PHONE NO <br /> ADDRESS_1 Q 3 W. 1yI Pj� y <br /> FILL; ADDRESS LEAD AGENCY pg�$ <br /> ,gCJ03 E Ilan7mer 4') rkh5n <br /> rl r= ,(,n mc. t6rL ?j5,31 - <br /> m arm 95a► a <br /> .170 2 F- k4mirn�r bclkkall -.q 1591 <br /> & 03 r 52/ <br /> 24 '79 AiM Owkr Cjkle, lx tW qS-214 <br /> kr rtlC AaMiE q 5 2-12 <br /> Cer7k1 LJ*)dian Rszl <br /> ` Z(X l AXItO �'r n�rr r lrrt `TS 2 <br /> 8 8 Rsc10 Cera�cr Dn1� 4;+rx 1rfr�r, 951.2 <br /> THIS NOTICE IS SUBMCT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICRS/ENVIRONM&NTAL HEALTH DIVISION(214D)POLICY M-M,ORDINANCE CODE OF SAN <br /> IOAQUIN COUNTY, E UD FRES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND 17TH EVIDENCE CODE. <br /> 1. A MAXIMUM OF TEN (10)PRIENTSE ADDRESSES PER REQUEST. <br /> 2. PUBLIC FILES/RECORDS REVIEW ARE BY APPOINTMENT ONLY. APPOINTMENTS ARE <br /> ARRANGED BY CALLING (269)468-0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 A.M, TO 12:90 NOON AND 1:90 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 BB RETURNED TO THE APPLICANT IF TLTE PILES/RECORDS ARE <br /> NOT AVAILABLE WITHIN THE CUSTODY OF THE MID. <br /> 4. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. THE BALANCE OP THE CHARGES ARE DUE AND PAYABLE MM TO REVIEWING THE <br /> DOCUMENT(S). <br /> 5. PUBLIC FILESMECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY THE EM STAFF AT THE EXPENSE OF TELE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL BE BII.LED TO THE APPLICANT FOR PAYMENT. <br /> 6. ORIGINAL PUBLIC FIIT:SIRECORDS SHALL NOT BE REMOVED FROM THE ERD PREMISES. <br /> SIGNATURE OF APPLICANT . / DATE / 9 <br /> SIGNATURE OF RELEASING CIAL DATE <br /> EH 00 14(REV 12192) <br />