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I VU la (KEv s�i�-il • SAN JOAQUI��i COUN'rY • _l,�i 04).{�ic� 71 `�5/off 3 <br /> PUBLIC lIrALnI SERVICES <br /> i tvtiIRONMHNTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT PHONE NO <br /> ADDRESS___171a <br /> AGENCY" NAA1H I PHONE NO <br /> ADDILESS_ t p Msj)a 1,j- f SZv, r A 9 32D <br /> i <br /> I <br /> EM A.PPRESS LEAD AVjMIQY !pg <br /> AL <br /> S l ckI c- <br /> 717-1 SL <br /> 647,14 &AL <br /> TINS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE RUC HEALTH <br /> SERYICM. ENVIRONMENTA4HSAI-TH 1HVISION (EHD)POLICY 144.007. OIWI14ANCE CODE OF SAN <br /> JOAQUIN COUNTY. END PEES AND SERVICE CHARGE RESOLUTIONS, STATS WATSI CODE. <br /> GOVERNMENT CODE AND THE EVIDENCE CODE <br /> I <br /> 1. A MAximuM or TIM (10) PPMALS9 ADDItImis PSR REQUEST. <br /> .I <br /> 2. PVBuc FILESIRECORDS REVIEW I6 aY APPOINTMENT ONLY. APPOW MENTS AS AURAHOW BY <br /> CALUNG (209"-0340. OVPF= HOURS FOR AFF0117MP?TTS ARE SCHBDVLEO MO,40Y TNRU MDAT <br /> EXCLUDING HOLIDAYS, 3:00 Am TO 12:00 NooN AMD L•00 tM TO 1:70 M. <br /> 3. A PURLR' RICORM Rg"g AMJCATION(PARA)IS RMDtBD. <br /> 4. PUBIC FLLES/RECORDS NOT'RSTUAM IN TUB ARMS CONDITIgH A3 RCCBWCD CS CORRBCTBO <br /> BY THC EHD STAFF AT THS rxPENS6 OF TND APPLI[AHT. THIS ADOn"AL smomm wILL ¢ VMLW W To THE <br /> APPLICANT FOR PAYMENT. (SEE EHD PoUCT 04-W7) <br /> S. 4RlolNAL PUBLIC FILEWRECORDS SHALL M&r 55 REWVBD FRO14 T"SHO PREMIM <br /> SIGNATURE OF APPLICANT DATE q — <br /> SIGNATUREOF RELEASING OFFICIAL DATE <br /> No PHSIEHD RmoRDslPlw ARP IpENTwim <br /> nm ea.iw+r m b.wltfan dNa: <br /> I - <br /> PHsJsRD IRECORj)7/PILEs Sxwr op THB ADDRsss(Ct)NOTED. You will,/i NmncD Mr <br /> RaC0"S/FiuS ARE AVAILAYLB FOA RIMXW_ I <br /> Mm a.c � <br />