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' SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> �ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> �— APPLICANT I/ L . �f roe, PHONE NO <br /> ADDRESS 307-7 <br /> AGENCY NAME L i.- E I r' PHONE NO <br /> ADDRESS <br /> FILE ADDRESS LEAD AGENCY P� <br /> C n,,y <br /> X20 I ` cCIAOt RECE <br /> f 1 �•�� ✓�1� _ ��� cA M 2 M3 <br /> s��A4� r ;vTr <br /> 650 �q iii �v-- o�rt��( RI�NEALTH SE►R'4It <br /> PFJ <br /> ENVIRONMENTAL <br /> s C e <br /> A <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN ZIPS PUBLIC HFaI TH <br /> SERvICES/EN' MONMF`1TAL HEALTH DIVISION(EHD) POLICY(192-007, ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, D FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE THE EVIDENCE CODE. <br /> i. PUBLIC FILES/RECORDS REVIEW ARE BY AP N-UNfENT ONLY. APPOIN'T'MENTS ARE <br /> ARRANGED BY CAIJ I G (209)468-0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY TI-IRU FRID Y EXCLUDING HOLIDAYS, 8:00 A.M. TO 12:00 NOON AND 1:00 P.M. TO 4:30 <br /> P.M. <br /> 2. A PUBLIC RE RDS RELEASE APPLICATION AND A NON-REFUNDAR DEPOSIT OF $78.00 <br /> IS REQUIRED. DEPOSTrS WILL BE RETURNED TO THE APPLICANT IF THE Fn-ES/RECORDS ARE <br /> NOT AVAILABLE THE CUSTODY Of THE FND, <br /> 3. THE ABOVE IDiENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. THE BALANCE OF THE CHARGES ARE DUE AND PAYABLE PFJO$ TO REVIEWING THE <br /> DOCUIMENT(S). <br /> 4. PUBLIC FILES/PECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BYTHE 'EHD STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WU-L BE TO THE APPLICAPIT FOR PAYMENT. <br /> 5. ORIGINAL PUB C FILES/RECORDS NOT BE REMOVED FROM THE END FR�KSES. <br /> SIGNATURE OF APPLICANTC — DATE Z 9 <br /> SIGNATURE OF RSLEA SING OFFICIAL DATE <br /> EH 00 14 (REV 10/92) <br />