Laserfiche WebLink
�:np.1 ._�/?nr�ll I rr CriUrl'rY <br /> P1J131,Lr� iRdAI,:CR S!s'.[JV7l•1?g <br /> EhP72ROW4RlJTAL HEALTR Il7:V L TON <br /> /�PUBLLC /RECORDS RELEASE APPLICATION <br /> AI?1'I.f/_AN'f' �'Y1+ It`duC/ �,t f�4•' ..... PRONE NO -�. J7/Gt7kl <br /> ADDRESS '*a d.J. 117i JS.ev LL> , — <br /> At;l�Nt."t NABil: %.:F� 5--E-;?7i) AUNR NO <br /> ADDRESS .. _T� <br /> ht k44 iii*44 F4RRFi 4d MFF +i + Rf + + tM4' + + 4.kidti k'A.k F titin ii ii htii RiAi ii4F <br /> FUI,,U- AUUR9'3 S BUSINESS NAME/ 1>Rrx';RAM ,)R <br /> FA(',TT TT" TYPE OF PCLCL, <br /> Ploo...-�/V•�'-�5.� <br /> ((cid') E-fJ � <br /> 1 7-Z 5 - ---- f Aj a n Z d eL- , <br /> + . tY 4lI V'F**i*.w**iii*iaf`R1 �i4#k**Fi iiii i*F4a FAlR ii tiitl'4'F'. i1 '41tk�'.ki <br /> 11115 NO f ICF IS SIJFr-IFC_I 10 H-IF 11FOUIRFMFNTS IDFNTIFIFD IN THE PUBLIC HEALTH <br /> SERVICES/EPII?IRONMENTAL JILAI..TiI DIVISION (FT ID) POLICY J94-007, ORDINANCE CODE OF <br /> PAN .JOAOLIIN COUNTY, EHD FEE AND SERVICE CIIARGE RESOLUTIONS. STATr WATCR CODE, <br /> (;OVFItNMFNI CODE AND THE EVIDENCE CODE- <br /> '1 A r4AMIMUlul OF TEN I nt 111tFMISF A1)IJRFSSFS PFR RFOUFST <br /> 2. PUBLIC rILESIrECORDS REVIEAY IS: BY APPOINTMFNT QNLY,APPOIN-1MFNIS ARF PROCFS$ - <br /> FD BY CALLING (20M)468-3420. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> THRN FRIDAY EXCLUDING HOLIDAYS, 9:00 AM TO 12:00 NOON AND 1:00 TO 4::10 PM. <br /> it A YUI'1 IC hll FF+iI(F(:(11{U`i I{hl hAtiF AF'I'I 1(,A I ION 11'I7HA1 1$ RFl1U1RN]. <br /> 4 PIIPLIC FIl_EGIrECORDS NOT RETL/R11E(1 IN THE SAME CONDITIOrr AS RECEIVED WILL EC <br /> rOR1tCCTED BI( THE EHD STAFF A r THE Exrr-rJS[ OF TiIE Ah'PLI';ANT. THIS ADDITIONAL <br /> rF-1'VIt;P WFIL VE RFLLED IO IHF AI'I'IICAPJI ICI( PAY'MINI (511 1)01) <br /> 5, ORIGIIIAL PUFLIC FILESIRECORDS SHALL NOT BE((REM0VED FROM THE EHD PREMISES- <br /> . . . ... .. . .w_. ... ....... ..• • ..'w� I....� f ........ ........... . ..... ...... <br /> *aGr.'ATURE OF APPLICANT r. 4 4�d It,,,.`.ii��J � DATE <br /> QIf;P1ATlIPE r,c nEl FASIr1C oFFiry/,(. DATF <br /> F11 ,,,1 14 naF,i l)/9r.1 ----- <br />