Laserfiche WebLink
FRON : GEO-PHASE ENV IR(OITFL INC P1,17NE 1,10. : 209 569 00 (j�YLc�! P02 <br /> SAN JOAQUIN COUNTY <br /> PuBL,IC HEALTH SERVICES <br /> ENVIRONMENTAL HEA1;tH OTVISION <br /> PUBL <br /> I <br /> ICC RECORDS RELEASE APPLICATION <br /> APPLICAPI'f L �_k -�'�F�},7S fJ ►J PHONE NO -60. _.. (02 <br /> ADDRESS _ , { VE�jy�N <br /> AGENCY NAMfi _�=N PHONE0� _ <br /> ADDRESS _... -. - . ._.- . <br /> aa*aaa •## kk aaaaa aa#}#!};###a##aaaaa}aaa#a it*if<4 { 4aftt *####R * R4t4 <br /> FUL7: ADDRESS WaTtiESS NAME/_ PROGRAM OR <br /> -FAC-TI-TTY TYPE OF 1711,131683 E. r hJ - - - SyMwi,t Q ,ippw _�(] <br /> I b'SI E LOJ55E. AJ£_ <br /> N N+�1'�l.YhtM..Y��1 n I• I• <br /> it �r Ir ,r 'Q-M9lf-N M�1E1� 1��611s�Y -- <br /> �I12-C. t.au156 rc I .A<,.\m 'S•ALLS 1n 711- <br /> 163 IA 1 <br /> 00 . Lc, ISS AlC' CBS D _ y <br /> }}#a is aaaaa aiaaaa#aMa}a#aafaaaa* aaa}tai##itika44##i♦# { ####ak4#t 4i <br /> THIS NOTICE IS SUBJECT TO TI IC REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICESIENVIRONMCNTAL HEALTH DIVISION (EHDI POLICY #94007. ORDINANCE CODE OF <br /> SAN JOAQUIN COUNTY, EHD FEC AND SCRVICE. C11ARG£ TIESOLUTIONS. STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1. A MAXIMUM OF IM (101 PREMISE ADDRESSES PER REQUEST <br /> 2. PUBLIC FILESIRECORDS RCVIEW IS EIY APPOINTMENT QNLY. APPOINTMENTS ARE PROCESS <br /> CO 13Y CALLING (20914613-3420. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> THRU FRIDAY EXCLUDING HOLIDAYS, 0:00 AM TO 12:00 NOON AND 1:00 TO 4:30 PM. <br /> 3. A PUBLIC FILESJRECORDS RELEASE APPLICATION IPRRA) IS REQUIRED. <br /> 4. PUBLIC FILES/RECORDS NOT RETURNED IN T11C SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY THE EHD STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL BE BILLET) TO THE APPLICANT FOR PAYMENT- ISEE EHD POLICY 94 0071 <br /> 5. ORIGINAL PUBLIC FILES/RECORDS SI IALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> SIGNATURE OF APPL1CANt�_ L� v. DATE <br /> SIGNATURE OF RELEASING OFODATE <br /> Eli 00 14 (REV 91961 rr <br />