Laserfiche WebLink
�y 30 --gfi o2 =21p <br /> e <br /> SAN JOAQUIN COUNTY <br /> PUBLIC ARALT,Tll SISH5l-LC&S <br /> ENVIRONIM[ TAL ITRALTH DIVISION <br /> )PUBLIC P-8CORDR RRLRASS APPLICATION <br /> A8T?LICANT_J0AW)A,hlber PHONE <br /> ADT'RlZ s3 f ef- r"Ipkoor Qc <br /> .AGENCY NAME FArt _, . PTIO NO AI E2 2o.i1-__`3.1r� <br /> ADDRESS <br /> 3#*'+F*itiF* k*1c� 1 i ►**t'tftt*t*�*rt**Y1kY�it*tt�►****#**i #i*}**!=Yty►}***yt rl <br /> MULL .ArTQ9.USk Nffl�W/ <br /> L' iL�T)C <br /> 11R9 QrLI FILL <br /> 1 L4 ! R A ``Dkjf 4 11LV LAL-1�it � T � <br /> 621�t5E AYE o f A o�c> S l LO 5 T` <br /> S A V 5}r` FfA L l�E(L�2S 1 S r L-14 f.'r ,� ! <br /> 5100 I ASI' i�u l AYE -01aL��5-faIGQ f,I,ASS (r�lll�� - <br /> mQwdkv6A'm fs 161 co 00 0ARLA.0 ZD <br /> THIS NOTICE IS SUBJECT TO TIME REQUIREMENTS IDEWrIFlED rN T»E PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL HEALT14 DIVISION {EHD) POLICY 494-007, ORDINANCE CODE OF <br /> SAN,10AQVIN COUNTY, EHD FEE ANIS SERVICE CHARGE RESOLUTIONS, TrATIE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODIE. <br /> 1, A MAXIMUM OF 3'I#I= PREMISE ADDRESSES PFR REQUEST <br /> 2. PUBLIC FILESiRECORDS REVIEW IS BY APMIKrMMX OWY, APPOINTMENTS ARE PROCESS- <br /> ED BY CALLING (209K683420.OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> TMRV FRIDAY EXCLUDIMG HOLIDAYS, 8.00 ATN TO 12:00 NOON AND 1:00 TO 4:30 RM_ <br /> 3. A PUBLIC FILESIRECOROS RELEASE APPLICATION ;PRAA) IS REQUIRED. <br /> 4. PUBLIC FILESMECORDS NOT RETURNED IN TILE SAME CONDITION AS RECEIVED WILL BE <br /> COMIECTED BY THE EHD STArF AT THE EXPIENSE OF THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT, (SEE EHD POLICY 94. 007) <br /> 5. ORIGINAL PUBLIC FILESMECORDS SHALL NOT BE REMOVED rROM THE EHD PREMISES. <br /> w *. +...•+as*a.►♦r..♦r.ifl ....4.ai. i...............**......ry*}#i........ <br /> SIGNATURE OF APPLICANT_.___Qg, ,d_ UU DATE <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> 4ti 00 14 (REV 9M) <br /> TOrFv_ P.02 <br />