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# 9?'ET, <br /> SAN JOAQUIN COUNTY <br /> PUBLIC 11CALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> `.'. PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT L/lL.Lt�cQ �YkS PRONE NO <br /> ADDRESSo!.»J'r),4iPe AN70A7, 64 rIVSff <br /> AGENCY . NA`ME ! /� SdPa�7S !�!G- PHONE NO <br /> AUDRESS ------------ ---. . -. <br /> laii♦'### #* t*##* i * i #a#*i* *k4k i#*##**# i-i*k###'ii * ii ik4 ki*##*##*# ##a* <br /> I?[JL1 All DRE�$$. BUSING'^u,. NAME PP_ RAM_OR <br /> FACILIT:� TYPE OEFl" <br /> Na i✓ �De 15kr n 1-kA C'e-li �a l�1 e U ule lr-Ta f+v <br /> _Ra_o s_ _ crShw S7 <br /> a ti S�✓r a tA/ e - loeess:K t T <br /> 1. ✓1r� Glk�l 4iM1/LN 1. Mr✓c1 /Taittr.L+n T <br /> JL <br /> _ tL S ffu S <br /> ! u yan nc�Pl S,lyd_ _ $moo L u S _ <br /> l2JNWrSlil'� n.Sf✓f � 6 efeo�7/*n9 _LL <br /> J�lS r <br /> Naf/u !�n✓G ++ amu, Cnn e s app. -s <br /> M4#kk* itik#**####4*#######***####* i** <br /> 'I'I IIS NOTICE 15 SU8.JECT TO THE REOUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICESIENVIRONMENTAL IICALTH DIVISION IEHDI POLICY #94-007, ORDINANCE CODE OF <br /> SAN JOAOUIN COUNTY, EHD FEE AND SERVICE CHARGE RESOLUTIONS, STATE WATFR CODE. <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1 . A MAXIMUM OF -TEN .(1O PREMISE ADDRESSES PER REVUES 1 <br /> 7. PUBLIC FILESJRECORDS FIEVIEW IS BY APPOILAY-W,ENT ONLY. APPOINTMENTS ARE PROCESS- <br /> ED BY CARING 12091466-34 20- OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> I'HRV FRIDAY EXCLUDING HOLIDAYS, 8:00 AM TO 12:00 NOON AND 1:00 TO 4:90 PM. <br /> 7. A PUBLIC FILES/RFCORUS RELEASE- APPLICATION (PRRA) IS REQUIRED. <br /> 4. PUBLIC FILESIRECORDS NOT RETURNED IN TI IE SAME CONDITION AS RECEIVED WILL BE <br /> C'URHFCTEO BY THE EMD STAFF AT THE FXPENSE OF TIME APPLICANT. TI IIS ADDITIONAL <br /> SERVICE WILL BE BILLED 70 THE APPLICANT FOR PAYMENT. (SEE EHD POLICY 94- 007) <br /> 5. ORIGINAL PUBLIC FILESIRECORDS SHALL NOT BE REMOVED FROM THE CHO PREMISES. <br /> • . . _• • • • • <br /> . . .......... ..... . ... . .. .. ••........_............. .. ....... <br /> SIGNAVURE OF APPLICANT .� <br /> .... <br /> / DATE S-�-II'I <br /> (1D1J11c�LlR,_ 71L - <br /> SIGNATURE OF RFI EA SING OFFICIAL__.. .__ _ _ . DATE <br /> EH 00 14 (REV 91961 <br />