Laserfiche WebLink
0 21994 SAN JOAQM COQ war, Uo -171zz I <br /> PUBLIC RMLTH SERVICES ! <br /> EN VIRONAdE 'AJL HEALTH DIYI<'4'iON <br /> "MLIC RECORDS RELEASE-APPLICATION �Gu L� • �L <br /> "F UCANT n n-1.5 I MOM NO <br /> ADDRM G Of 5-a oft '2--L-K <br /> A4:404CY MAM ' t r Asdr,S CA PHONB NO <br /> ADD= <br /> mmurm,Mil AY Z 9 M41 <br /> ELLE APPRESs LEAD AGENCY ENVIRON AL HEALTH <br /> � <br /> :ER?�I /SERVICES <br /> THIS NOMCS 13 SU)UECT To THE RE IREMENTS IDENTIFIED IN THE PUBLIC HEAJ Tkl <br /> SMV1C SfM4VIR0NMENTALHEALZH I7NY N{IIHD}POLICY#92-W,OFJD MANCE CODE OF SAN <br /> 30AQLgK COUNTY, EUD FEES AND & CHARGs RBSQLU'noNs, SLATS WATM CODE, <br /> GOVERNMENT CODE AND THB btill DE. <br /> I. A MAXEMM OF (10 SFs ADDRSSSES <br /> 2- Ia[]BLIC VIEW ARE hM&jff gNLX. APPOINTMENTS ARE <br /> ARRANG G 2-0340. OF UltS FOR APPCINIIAWK13 ARF SCHEDULED <br /> MONDA Tk>;Rv �Y . 8:W A.M.70 12:00 NOON AND I:bU P.M.TO 4:30 <br /> P.M. <br /> 3. A P ORDS LIGATION <br /> 113 rk in b" IS w WQQFQ6 A" <br /> 4. <br /> He6'i3l4fe+�3y: . <br /> 5. PUBLIC MS/RECORDS NOT IiE[URNSD IN THE SAMS CONDMON AS RECEIVED Wa L BE <br /> CORRECM BY THE 6" STAFF AT THE EXP> 36 OF TM AMICANT. IMS ADAITLONAL <br /> SERVICE WILL BIi 011A [)TO TFIE APPUCANF POR PAYMENT. <br /> 6. ORIGINAL IPUB11C FU"RECORW SHALL NOT BE RHMOVM PROM THE ROD PREWSES. <br /> SIONATURE OFI'iPI1 DATEfj <br /> - <br /> SIGNATURE OF R RX5.A LNG FFtlDATE <br /> EH 00 14(REV 12/92) <br /> ZD'd 8&9ZZ96976T Q.L 4Uad t ues:L0 tm%T-•9Z-S0 <br />