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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICE' <br /> -M V RONM ENTAL HEALTH DI00!110N <br /> ��// PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT Ylevil'�/ f�e✓S�yts PHONE NO <br /> ADDRESS SB�:3t5 1 S,L3Y0 i2 w /1ic .(r SL (eoc' ' <br /> AGENCY NAME PHONE N <br /> ADDRESS <br /> FILE ADDRESS pA LBAD AGENCY DATE <br /> Wolof 5�1f cte'S <br /> L°129 W. rfa .lc,: �..0 <br /> 6 1-1 PAYMENT <br /> Rpc D <br /> 0 .G;,.� =.,n111 31i(arvi in MAR 17 1994 <br /> _ <4rc V-4~ c `lecn SANUNT1'— <br /> PURI I(.HEAI TH SERVICES <br /> to L j, i-Z s• aio{ L�,,,`��� _\ ENVIRONMENTAL HEALTH DIVISION <br /> C4 er LaLi�rs.,l\ \ <br /> THIS NOTICE 1S SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION (EHD)POLICY#92-007,ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, EHD PEES 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 ARE BY APPOINTMENT ONLY. APPOINTMENTS ARE <br /> ARRANGED BY CALLING (209)468-0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 A.M. 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$78.00 <br /> IS REQUIRED. DEPOSITS WILL BE RETURNED TO THE APPLICANT IF THE FILES/RECORDS ARE <br /> NOT AVAILABLE WITHIN THE CUSTODY OF THE EHD. <br /> 4. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. THE BALANCE OF THE CHARGES ARE DUE AND PAYABLE PRIOR TO REVIEWING THE <br /> DOCUMENT(S). <br /> 5. PUBLIC FILES/RECURDS NUI' O:I URNhll 1N THti SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY THE EHD STAFF AT THE EXPENSE OF THfi APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. <br /> 6. ORIGINAL PUBLIC FILESIRECORDS SHALL NOT BE REMOVED FROM THE END PREMISES. <br /> SIGNATUREOFAPPLICANT v-v } _7 -coo DATE 3/16/9y <br /> rSIGNATURE OF RELEASING OFFICIAL DATE <br /> b EH 00 14 (REV 12/92) <br /> TOWL P.02 <br />