Laserfiche WebLink
• SAN JOAQUIN COUNTY 0 <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE REQUEST FORM <br /> IND IVIDUAL NAMEea Ak-1 -6 Z4A,11. PHONE NO(Z��- zavc) <br /> ADDRESS ZIS W ��� 4U_ ��ovts ! - <br /> AGENCY NAME PHONE NO <br /> ADDRESS <br /> FILE ADDRESS LEAD ENFORCEMENT DATE OF <br /> AGENCY REQUEST <br /> � l l TJAVy 'D(2-� STzZKTcPJ Zc o)C <br /> rt?-4C 1,jAy y cDg . s-rr-Zl:f-a,nJ <br /> ISP ToA/ <br /> Py 4i l rjU pkv• S7zx Kta✓ <br /> I v , <br /> 0 3`� w • ct1A,z'rtrn unY �-;�eio,.l i,��1 �;1 <br /> (CA15 W-G{o�RYLw�y S UGI�tZYI <br /> 1l Za W' "Alrl WAY s7tx4c_-2YJ <br /> 1l 4 S W G4Ip4L7Zn2 why. S k-- p J <br /> W• cl{!dL ,yl ttra st i C K71 <br /> ,I�S,c77V-J - CG{r'dC1TrCccnry sz i K tr / <br /> C L4PKLL;rW CLAY S7TXK7 kJ � <br /> 1 S s L t K.r(.oLAJ >t - 5704K J <br /> C 1004 I`xAV U(-- • S k N <br /> Yes N-Nyy p _ STzr.Kz� <br /> San Joaquin County Public Health Services Environmental Health Division files are considered public records <br /> except for certain documents identified in the Government Code and the State Water Code. <br /> Requests for public records or file reviews are subject to charges established in San Joaquin County Rules and <br /> Regulation Environmental Health Permit Fees and Services Charges. <br /> Charges for records or documents requested by subpoena duces tecum are subject to changes established in <br /> the Evidence Code. <br /> Photo copies of public documents are subject to Public Records Policy #91-001. <br /> SIGNATURE OF REQUESTING PAR / <br /> - DATE <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14 (REV 3/91) <br />