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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT Xenl E' ? rrill/l PHONE NO 4(6 9 9 ' 3. 3Y� <br /> ADDRESS R3 /0 C-A 8wOafc1fvr2-s'0 /Vo!4` sAcr__queNFu �¢ gS833 <br /> AGENCY NAME PHONE NO <br /> ADDRESS <br /> FULL ADDRESS BUSINESS NAME PROGRAl4 OR <br /> FACILITY TYPE OF FILE <br /> ffFrn 9f'zo(, ©Hcrc7f, .Z'�c �,/ ol' Gws 5•faelrwn <br /> �yq 5 S1anrsrav� -1 ot — G�s s�a,�cw+ <br /> 8!9 5 SfAr 's(As Sfcrnari ` JL^1Sy G�eieilnc.� of _ aS Sv4dtvh <br /> �o-F S, Ga(t(+rnlo� sicarnaS�uz � tiN V w fForas t f� '� - <br /> 3oo S rmllifor4 0a 91K}n 46�o4 _SKIPS S¢rvice SiwFro s � m( - (ray Spta7Lrcn <br /> / ur_ S GA(ill .�1a Sft rn ar�3 n A.H�rh,.0 tira4ofmr 4.Frr�O f7/- Ga c �1rAl�to rn <br /> sYFPnws r-"'xy �I FnLr(ea�e, 1Hc.U,5 ®( 1;af Sala Xco n <br /> Ga <br /> '.�1 sfiRrin4. ao(c" SYou<�Con 1>(w7ra�,� c �z� s�- s fra lia <br /> d M <br /> tiJ IC <br /> r Q s.1e1EcCTic_ 6.w1 fglfo'iG �IJ O! GAS $ ("Vf(o•J <br /> f"3S S• GCN1C STKTn np <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION (EHD) 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 00 PREMISE ADDRESSES PER REQUEST <br /> 2. PUBLIC FILES/RECORDS REVIEW IS BY APPOINTMENT ONLY. APPOINTMENTS ARE PROCESS- <br /> ED BY CALLING (209)468-3420. 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 FILES/RECORDS RELEASE APPLICATION (PRRA) 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 ADDITIONAL <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. (SEE EHD POLICY 94- 007) <br /> 5. ORIGINAL PUBLIC FILESIRECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> ..............*....... .. ..... -.. . ..... . DATE•) 3 O ..Q.......... <br /> SIGNATURE OF APPLICANT <br /> SIGNATURE OF RELEASING OPFICAV V✓ DATE /AI <br /> EH 00 14 (REV 9/96) <br />