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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> AAPLICANT "� 1 L UL I�' c..IIY\ �L �1✓� PHONE NO (,Kl )cllA""lslA5 <br /> ADDRESS cjt� 5 <br /> AGENCY NAME PHONE NO <br /> ADDRESS <br /> +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ <br /> FULL ADDRESS BUSINESS NAME/ PROGRAM OR <br /> FACILITY TYPE OF FILE <br /> BIS LOb� 1 i r 1. �1� . w--'T'L <br /> iI)'lltl.Ix ALL LL, / ...l <br /> n t- <br /> Y'Y` I- <br /> I 1-1 o I I IL/ f ) N� L--T/N L,-. cR�'T <br /> 11 Iv <br /> 111;t, E.I\'41� p � <br /> 1 <br /> 'WLL. -- ILI,..f i,l t) l--J--_-5 <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION (EHD) POLICY #94-007, ORDINANCE CODE OF <br /> SAN JOAQUIN COUNTY, EHD FEE AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1 . A MAXIMUM OF TEN (10) PREMISE ADDRESSES PER REQUEST <br /> 2. PUBLIC FILES/RECORDS REVIEW IS BY APPOINTMENT ONLY. APPOINTMENTS ARE PROCESS- <br /> ED BY CALLING (209)468-3420. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 AM TO 12:00 NOON AND 1:00 TO 4:30 PM. <br /> 3. A PUBLIC FILES/RECORDS RELEASE APPLICATION (PRRA) IS REQUIRED. <br /> 4. PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY THE EHD STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. (SEE EHD POLICY 94- 007) <br /> 5. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> hl <br /> ..... ....................t.............................L............_.7...... <br /> SIGNATURE OF APPLICANT . DATE <br /> SIGNATURE OF RELEASING OFFICIAL n DATE lX <br /> EH 00 14 (REV 9/96) <br />