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10-26-1994 08:122AM FROM L04)R'i/KRPZPN TO 12094640138 P,01 <br /> • SAN JOAQUIN COUNTY 1'w,J :Aym 4,d <br /> PUBLIC HEALTH SERVICFS cz�7vty- 0133 . <br /> gyMo NMENTAL HEALTH DIVISION /3S6 <br /> PUBLIC/ RECORDS RELEASE APPLICATION ," 3 ,,, el <br /> APPI <br /> ADDASNIZZn f v��1tS�G'a�f /23 C r we c4PHONE NO �I6 <br /> t7 S O b <br /> S!S <br /> AGENCY NAME PHONE NO <br /> ADDRESS <br /> n�,lrjr.:St Za.,c V <br /> FILE AI)DRI3SS sks, I.RA17 AGENCY DATE <br /> o 16-32, N, &xa..Jw^ , <br /> 0 IROS N. a.oad i leo Ij on I% — <br /> 3127. EFrcuo.+ S¢. <br /> pCI 2 {o 1994 <br /> 0 1013 N Ste, ki, tom �6-0 l <br /> 6y8 � ---- t�vvrRuiviv�uvTA����— <br /> ERVICEs— <br /> y <br /> '[HIS Narfc,13 is SUBJECT To THE REQUIRED SPITS IDENIIFWD IN TIB PUBLIC HEALTH <br /> SERVICBSfBNVLRONMENTALHEALTH DIVISION(EBI )POLICY M-007,ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, WID PEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER COD& <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> I. A MAJQMUM OF TEN(10)PREMISE ADDRESSES PER REQUEST. <br /> 2. PUBLIC FILEMCORDS REVIEW ARE BY APPOINTMEPTL' pNLY. APPOINTMENTS ARE <br /> ARRANGED BY CALLING (7A9)4681I340, OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 A.K 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 OP 178.00 <br /> IS REQUIRED. DEPOSITS WILL BE RETURNED TO THE APPLICANT IF THE FILESgIlCORDS ARE <br /> NOT AVAILABLE WITHIN THE CUSTODY OF THE ELID• <br /> 4. THE ABOVE IDENTIFIED DEPOSTT IS APPLIED TOWARDS TIME TOTAL ME REVIEW FEE <br /> CHARGE THE BALAOICE OF THE CHARGES ARE DUE AND PAYABLE FRI TO RBVLEWING THE <br /> DOCUMIRMS). <br /> S. PUBLIC FllF3/RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY THE EHD STAFF AT THE EXPENSE OF THE APFUCANT. THIS ADDITIONAL <br /> SERVICE WILL. BE 8I11 TO THE APPLICANT FOR PAYMENT. <br /> 6. ORIGINAL FUHUC FILESIREC'ORDS SHALL NOT BE REMOVED FROM THE BED PREMISES. <br /> SIGNATURE OF APPLICANT �� 7Fr DATE <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> FII 00 14(REV 12192) <br /> (C%�' - TOTf7L P.91 <br />