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SAN JOAQTJE'4 COUNTY <br /> &PUBLIC HEALTH sERVICES Qs -'2 7 <br /> F�7IItONII LNTAL HEALTH DIVISI U/vZ3 y <br /> !� PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT 9 (/1'I" A , PHONE NO �O�- �r� -13 <br /> ADDRESS 0829- C . s 7- <br /> AGENCY <br /> AGENCY NAME K.le/n PHONE <br /> ADDRESS <br /> FU.E ADDRESS LEAD AGENii CY DATE <br /> 5441 �' &-s S f COu t1 <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/&WIRONMENTALHEALTH DIVISION(EHD) POLICY#94-007, ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, = FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1. A MAMMUM OF TEN (10) PREMISE ADDRESSES PER REQUEST. <br /> 2. PUBLIC FILES/RECORDS REVIEW Is BY APPOINTMENT ONLY. APPOINTMENTS ARE ARRANGED By <br /> CALLING (209)468-0340_ OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY THRU FRIDAY <br /> EXCLUDING HOLIDAYS, 3:90 AM TO 12:00 NOON AND 1:00 PM TO 4:30 PM. <br /> 3. A PUBLIC RECORDS RELEASE APPLICATION (PRRA) IS REQUIRED. <br /> 4. PUBLIC FH.ES/RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE CORRECTED <br /> By THE EHD STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL SERVICE WILL BE BILLED TO THE <br /> APPLICANT FOR PAYMENT. (SEE EHD POLICY 94-007) <br /> S. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> SIGNATURE OF APPLICANT DATE <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> No PHS/EFID RECORDS/F(LSS ARE IDENTIFIM: <br /> Dwn �'®�r. iWmrunar Dwn: <br /> / PHS/EHD RECORDS/FR Fc FUST ON THE ADDRFSS(M) NOTED. YOU WILL BE NOTIFIED WEEK <br /> �. RECORDS/FILES ARE AVAILABLE FOR REVIEW: <br /> Own Revawm m Kn =w DAM. <br /> 1 (REV 5194) <br />