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{�1�Qasne,� I SArt 1OAQUMi COUNT <br /> i:—:::x:ppUBLIC gEALTH SERVICES <br /> mokcelved <br /> ' EIQVIF.Oh'AjENTAL 13BALIM DIVISION <br /> -� _ PUBLIC RECORDS RELEASE APPLICATIG., <br /> SEQ <br /> V.A0)SM NO D <br /> APpLICANTs?I� . <br /> ADDRESS pHONP- NO <br /> AGENCY NAME U ti <br /> ADDRESS <br /> Fax 14197- 111 <br /> FILE ADDRFC L�FAs-AG,ET�Y DAT33. <br /> �-- <br /> S ndS <br /> I -- a <br /> � tt <br /> t� C n tr <br /> noa �--asA 3 <br /> r 14 co <br /> 1'1p�l.�es <br /> THIS NOTICE 15 SUBJECT TO THE REQUIREMENTS IDENTIFIED 1N 714E PUBLIC HEALTH <br /> SERVICES/E1�V(RO>;? <br /> .j ENTAL} EA1 TH DIV]S10:1 (E-HD)POLICY#9 007, ORDI\AJ`CE CODE OF SAA' <br /> lOAQU1N COUNTY, FJ4D FEES LND SERVICE CHARGE RESOLUTIO,s. STATE WATER CODE, <br /> GOV);LN%JEN'T CODE AND irB EVIDENCE CODE, <br /> 1. A }fAkT iI1Sf OF TE, <br /> i (10) PRE)IISE ADDRESSES PER REQUEST, <br /> Z, PUBLIC F)LESIRECO.'v7S REVIEW :JtE BY <br /> AL N7 ENT ONLY. APPOINTISENTS ARE <br /> ARRANGED BY CALLING (?D=)458-0340. OFFICE HOURS FOR APPOINT'1.1ENTS ARE S[HEDULED <br /> 'fONDAY THRU FRIDAY E7 EXCLUDING HOLIDAYS, 5:00 A.15.TO 12:00 LOON IN 1:00 P.N.TO X5:30 <br /> P.M. <br /> 3. A PUBLIC RECORDS RELEASE APPLICATION AND A N2a: E DEPOSIT OF 578.00 <br /> ,RE15 REQED. DEPOSITS MLL BE R.> IUR_NED TO THE APPllCA.1'T IF THE F1LFSr <br /> UTRCORDS ARE <br /> NOT AYAILA:--" W1TT-0N THE CUSTODY OP THE RHO. <br /> 4• THE ABOVE 1DEN nFD DEPOSIT' IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. 714E B.4LANCE Or,,HE CHARGES ARE DUE AND PAYABLE I= TO REYIEaIITG THE <br /> DOCUMENT(S)., <br /> S. PUBUCPIL.ES/RECOJtDSNOTRBTUR'lEDINTHE SAAdECONDITIONASRECEIVEDWILLBE <br /> CORRECTED BY THE E.HD STAFF AT THE EYPENSE OF THE APPLICANT. TFUS.ADDrITONAL <br /> SFAI7CE WUJL BE BILLED TO THE APPLICANT FOA PAYMENT. ' <br /> 5, ORIGINAL PUBLIC FILFS/RECORDS SHALL- NOT BE REMOVED FROAi THE EHD PRE}IISES. <br /> DATE <br /> SIGNATURE OF APPLICANT <br /> SIGNATIME OF RELEASING OFFICIAL DATE <br /> Elf 00 14 (REV 17J92) <br /> --�o <br />