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Ell 00 14 (REV 5/94)%.,, SAN JOAQUIN COUN'T'Y <br /> PUBLIC IIEAI;rl C SEILVICr.S� �S- <br /> ENVIRONMENTAL ITT"ALTII DIVISION <br /> PUBLIC RE CORDS R.1-LEASE APPLICATION °� 3 <br /> .4 <br /> r APPLICANT__ tc, A) ('-r S PHONE NO q&3" 72Z y <br /> ADDRESS <br /> AGENCY NAME PHONE NO <br /> ADDRESS <br /> FILE ADDRESS LEAD AGENCY DATE <br /> JE a 7` - a ° <br /> a <br /> a1i »a i�5J <br /> 'MIS N ACE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PURL HEALTH <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION (EHD)POLICY#94-007, ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, EHD FEES AND SERVICE CHARGE. RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> I. A MAXIMUM OF TEN (10) PREMISE ADDRESSES PER REQUEST. . <br /> r: <br /> 2. PUBLIC FILES/RECORDS REVIEW IS By APPOtNTMENZ ONLY. APPOINTMENTS ARE ARRANGED BY <br /> CALLING (209)468-0340. OFFtcB HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY TIIRU FRIDAY <br /> EXCLUDING HOLIDAYS, 8:00 AM TO 12:00 NOON AND I:00 PM TO 4:30 PM. <br /> 3. A PUBLIC RECORDS RELISASE APPLICATION (PRRA) IS REQUIRED. <br /> 4. PUBLIC FILES/RECORDS NOT RETURNED IN THE, SAME CONDITION AS RECEIVED WILL BE CORRECTED <br /> BY THE EHD STAFF AT THE EXPENSE Of THE APPLICANT. THIS ADDITIONAL SERVICE WILL BE BILLED TO THE <br /> APPLICANT FOR PAYMENT. (SEE EHD POLICY 94-007) <br /> S. ORIGINAL PUBLIC FILES/RECORDS SIIALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> SIGNATURE OF APPLICANT DATE <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> No PHS/EHD RECORDS/FILES ARE IDENTIFIED: <br /> nATW. Rlmwpmo are NOrMICATM"OATnr <br /> PHS/EHD RECORDS/FILES=EXIST ON THE ADDRESS(ES) NOTED. YOU WILL BE NOTIFIED WIZEN <br /> ^ 1 / RECORDS/FILES ARE AVAILABLE FOR REVIEW: <br /> 13 f f DAtw: Rema�eeo ar. NottrCAtton l�nre <br />