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APPLICANT, <br />ADDRESS_ <br />AGENCY N. <br />ADDRESS_ <br />SAN 7OAQUIN COUNTY <br />PUBLIC REALM SERVICFS <br />ENVLRONMENTAL IIEAL'I'li D'"ION <br />�r'd'�'6 <br />PUBLIC RECORDS RELEASE APPLICATION <br />(- . rl _. Aa�gcxf�' ....iREIONH NO <br />�HA CY <br />EALTH <br />T1IIS NOT7CE IS SUWECT TO TIi I REQUIREMIiNTS IDCtdJC sgj-00TIME-O IN TIRE PUD11C II CSAN <br />ODE, <br />SERVICESlFNVIRON CND FEES- AND I)IV'S' E CIIARGELRESOLU•{'tONS,nSTA EC WATER CODE, <br />JOAQUIN COUNTY, <br />GOVRRNMENT CODE AND 1116 EVIDENCE CODS. <br />1, A MAXIMUM OF 1.01 (10) PREMISE ADDR"SES PER REQUEST. <br />,rnr•nnfNT ().LL APPOINTMENTS ARE <br />y PUBLIC fli_ESIRECORDS REVIEW ARE BY dCPS.ul <br />ARRANGED BY MONDAY T11RU FRIDAY I (21)9)468-0340- OFFICFRXC1.UDINO i1IIOUI)AYS, 8(00 ASM.07'O 11:00 NOON AND 1R Al'POINTNIENTS 1:00 P M`. CO �:JU <br />P.M. <br />O„a..c r. VU N DAR LE DEPOSIT O� i7B.00 <br />3. A PUBLIC RECORDS RELEASS APPLICKDON AND A h___y---- <br />IS REQUIRED. DEPOSITS WIjL BE RGIURNED TO TIM APPLICANT tF'I91E ryLESlRECORD+ ARE <br />NOT AVAILABLE W1TH1N TIIB CUSTODY OF THE ElID. <br />CHARGE,4. Ti'14113 BALANCE OPaIS'i� CHARGES ARE DUB ANNDAPAApTOTAL <br />ABOVE IDENT1FWP DEPOSIT IS APPLIED AELa 'RIO TO REVIEWING THE <br />DOCUMENT(S). <br />S. PUBLIC FILESIRFCORDS NOT RETURNED IN THE SACHIS 1S ADDITIONAL <br />ME CONDl11ON AS REWILL BE <br />CORRECTED BY THE EHD STAFF AT -Ilia EXPENSE OF 111E APPLICANT, <br />SERVICE WILL EE 91LIXD To IV13 APPLICANT FOR PAYMENT. <br />6. ORIGINAL PUBLIC PILES/RECORDS SHALL' NO"T BE REMOVED FROM "IE E11D PREMISES. <br />SIGNATURE OF APPLICANT <br />SIGNATURE OF R):hEASING <br />Ell DO t4 (REV 12192) <br />DATE 0�3�0/-�9 <br />DATA <br />W,-iF'01 t RFiC' L—I1P— L <br />