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7 -I2 -1y -fib ,j: G7YM rl"m' . .VIS. G[,... ...w <br />_J <br />SANIOAQM COUNTY G��j 1(o6 <br />rLTUUC HEALTH SERVICES <br />ENV,Rop ME TAL EEALTII DIVLSION <br />!PUBLIC RECORDS RELEASE APPLICATION <br />PHONE NO <br />AGENCY <br />ADDRESS <br />LEAD AGENCY DATIi <br />THIS NOTICE IS SUBJECT TO THC REQUIREMENTS IDENTIFIF-D IN THE PUBLIC NEALTI-1 <br />SF.RVICESIENVIRONMENTALHEAI TII DIVISION (FJID) POLICY p92-007, ORDINANCE CODE OF SAN <br />JOAQUIN COUNTY, EILD FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br />GOVERNMENT CODE AND THE EVIDENCE CODE <br />1. A MAXIMUM OF TEN (10) PREMISE ADDRESSES PER REQUEST. <br />2. p11BUC F91ESIRECORDS REVIEW ARE B' <br />ARRANGED BY CALLING (209)468-0340- OFFICE <br />MONDAY THRU FRIDAY EXCLUDING HOLIDAYS, <br />PI' I dTMENT ONLY. APPOINTMENTS ARE <br />HOURS FOR APPOINTMENTS ARE SCHEDULED <br />8:00 A -M. TO 12:00 NOON AND I:W Y.M. TO 430 <br />P.M. <br />3. A PUBLIC RECORDS RELEASE APPUCATION AND A NUN -REFUNDABLE DEPOSIT OF S78.00 <br />15 REQUIREb. DEPOSITS WILL BE-S,RETURNED TO THE APPLICANT IF T14E FIL -RECORDS ARE <br />NOT AVAILABLE WLTNIN THE CUSTODY OF THE EHD_ <br />4, THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br />CHARGE THE BALANCE OP THE CHARGES ARE DUE AND PAYABLERp AOR TO REVIEWING THE <br />DOCUMENT(S). <br />5. PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDITION AS RFCEIVED WILL BE <br />CORRECTED BY THE EHD STAFF AT THE EXPENSE OF TiIE APPLICANT. THIS ADDITIONAL <br />SERVICE WILL BE BILLFJI TO THE APPLICANT FOR PAYMENT. <br />6. ORIGINAL PUBLIC F1LESIRECORDS SHALL NOT BE REMOVED FROM THE EHD PREM15E3. <br />SIGNATURE OF RELEASING OFFICIAL DATE <br />EH 00 14 (REV 1.2/42) <br />