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t SAN JOAQU N COUNTY 7 -;7 <br /> PUBLIC HEALTH. SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT A e err r1 M 'K r h b+Fl PHONE NO <br /> ADDRESS <br /> AGENCY NAME f vaHrti _9.0 FmVJv6rl 'h•147a1 PHONE 110 9 <br /> ADDRPSS 1303 W March Ln jt r /} 510CK1oti <br /> F; 1•f 37>zcA ]aly 19R6 only <br /> FILE DSS LEAD�?_ENCY DATE <br /> 40. 1 N. 50" Jo.g,ui 5t-- ('H7- E H f <br /> 437 E. H;h•r_ v&. <br /> 14 ( _N. E I Aor.cj0 <br /> 601 _ AUq- <br /> VA3 � <br /> z4q E• pariS f C - t•� <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICESlENVIRONh4ENTAL HEALTH DIVISION (EHD)POLICY F92-007,ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, EHD 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. PUBLIC FILES/RECORDS REVIEW ARE BY APPOINTME ONLY. APPOINTMENTS ARE <br /> ARRANGED BY CALLING (209)468-0340. OFFICE HOURS FOR APPO@1TMENTS ARE SCHEDULED <br /> MONDAY THRU FRIDAY EXCLUDING HOLIDAYS, 5:00 A.M. TO 12:00 NOON AND 1:00 P.M. TO 4:30 <br /> P.M. <br /> 3_ A PUBLIC RECORDS RELEASE APPLICATION AND A NON-REFUNDABLE DEPOSIT OF S78.00 <br /> IS REQUIRED. DEPOSITS WILL BE RETURNED TO THE APPLICANT IF THE FILES/RECORDS ARE <br /> NOT AVAILABLE WITHIN THE CUSTODY OF THE EHD. <br /> 4. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. THE BALANCE OF THE CHARGES ARE DUE AND PAYABLE PRIOR TO REVIEWING THE <br /> DOCUMENT(S). <br /> S. 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. <br /> 6. ORIGINAL PUBLIC F1LES/XECORDS SHALL NOT BE REMOVED FROM THE F 4D PREMISES. <br /> SIGNATURE OF APPUCANT �L(il t DATE <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> F34 00 14 (REV 12/92) <br />