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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL F-EALTH DIVISION <br /> PUBLIC RE1CORDS RELEASE APPLICATION <br /> APPLICANT LF�tARt2 <br /> ADDRESS 1,01 }L Coro PHONE NO Cif OeAj7o <br /> AD — !! �- Fo Cr- <br /> ADDRESS <br /> NAME BONE NO <br /> -- <br /> *x*###t*#*##*++#+#+Y######.'###*i*#*##i###i+#i*i*#**###i•h*iia#p##* <br /> �L19INESS H NAME/ PROG& <br /> FACTS+ITY _. 11Ivt O�j <br /> TYPE OF Frr ^ <br /> ISPGb S. rec-k_els Rd. _ eCKkto Udb� ms}ruGr = <br /> �td_ _ P All <br /> Spricf4 ..�' Fug lA A I I (�✓ f \1Q > <br /> t'�1CWtssell — 'hada r.a Cha <br /> ¢�resif e. 42 <br /> Bt — a n Ctrr --u r <br /> —Lr133o S_ s ( _ - _ <br /> tsr <br /> Ern J <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION (EHDI POLICY #94-007, ORDINANCE CODE OF <br /> SAN JOAQUIN COUNTY. EHD FEE 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 IS BY APPgIjJUEhIT ONLY APPOINTMENTS ARE PROCESS <br /> BY CALLING (209)466-3420. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 AM TO 12:00 NOON AND 1:00 TO 4:30 PM. <br /> 3. A PUBLIC FfLESlRECORDS RELEASE APPLICATION IPRRAI IS REQUIRED. <br /> 4. PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY THE EHD STAFF AT THE EXPENSE OF THE APPLICANT. THIS APPLICANT. THIS <br /> ADDITIONAL SERVICE WILL HE BILLED TO THF APPLICANT FOR PAYMENT. (SEF. EHn POLICY <br /> 94- 007) <br /> 5. ORIGINAL PUBLIC FILESlRECORDS SHAI1. NOT BE REMOVED FROM THE EHD PREMISES. <br /> .M....ff1l........a....... ..+....• ....a..a....+.+.+.n+..as•.a•..aa.y... <br /> SIGNATURE OF APPLICANT- L_ _DATE R <br /> SIGNATURE OF RELEASING O 1 )AL •fLDATE <br /> EH 00 14 (REV 9196) <br /> 1 <br />