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- '_ �� r.�!_�fI ��� X13 V <br /> �' j , +^F <br /> sir J171'. T;Ity CG[,' 'CP PPi 2: 58 <br /> PUBLIC HEALTH SERVICES <br /> SI+iVIR(`il;!vTrTpLL HEALTH iTVisloN <br /> PUBLIC: ZECORDS RZLE'ASZ A,PPLICATION <br /> .aria 4-j-,/ _ _ <br /> APPLICANT I(,{�{��I_GF f �nft�l�.inlr��+J Jf[ PRONE. NO,—�610 <br /> ADDRESS- <br /> •k k k r� .,�fklr�•kir+rvr*3•,L k*�r#,k*�txtk*•tt+t+ t*!r*##'k•i••trrk,F tt#k#tlr#i•�r*•k•kx###irk <br /> Ful 1?J�GRR� FsI�SII3ESS -?qA K <br /> .AQiL177 TYPE OF TLE: <br /> 2,I't ) r•l. P{L'Z rFl L.�r�li SY«c.;,71+/ -Th '. (ii1.1 tA.f�� -,�f--- - - <br /> 4R�0 �L�t,CiK5��1i Rp t k.r: I _ 3TFAhfn / nlriJ,+�4C —lu <br /> n 351-/x_55 <br /> 2-7U1 L3, r�I�R!il cr{rJE ST<�CLfTdh' t�.�1CC/1� it <br /> *�#*-x-xxxxxrxyr* k **** } & A kkki.t L k 4A'kA � <br /> THIS NOTICE IS SULUECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> tIEKVIUE5lLNVjr%UNMI=N'fAL HtALIh 01VI51ON IEMU] POLICY #'34-007, OIiDINAN C C60C CF <br /> SAN .IOAQUIN COUNTY, EHO FEL-' AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GoLigRN�AENT COOS A.N0 THE Fl110FNIf_F CODE <br /> 1- A MAXIMUM OF TSN, 1.10) PREMISE ADDPESSLS PER REQUEST <br /> .r <br /> 2. PUBLIC FTLESr'I• rC,0RUS Rs=VICW IS BY , APFCINTM6?4T4 ARE RPOCESS <br /> EY CALLING, (309)-168 3120. OF;ICE NOURS FOR IkPPOIN MENTS ARE Sr-HFCii IL E5 540NI-IAY <br /> THRID FRIDAY EXCLUDING 14000AVG, 0.00 AM TO i'2-0C NOON AND i 14DO TO Ae3L1 faM. <br /> 3. A PUELIC FILESiRECORDS RELEASE APPLICATION �RI<FA) IS REQUIRBD. <br /> 4. PUBLIC: ;ILES1RECORDS NOT RETURNED IN THE SAME CONN]i ION AS RFCE)VI=D WILL BE <br /> CORRgC,TFT3 SY THE V0 STAFV AT THE E7(PENS€ OF THE AFFLICANT. TI-1I0 APPLICANT. THIS <br /> A"ITIO NAL CER'vICE WILL 131UILLED TO TI IC AFTLICANT CCI; PAYMEN - ISEF 1=iaE7 POLICY <br /> 94- 007) <br /> 5. URIGINAL PU8L IC FILESiRECORDS SHALL NOT BE pEIb70VED FROM THE EHD PREMISES. <br /> ... _ w+:3. ri+a t... ..... , , .... <br /> � 1 i. F f.1 f Y 1�i 4 4 7♦;4 1 i.f.t -�T. T T - .r <br /> S11-IJAr+JI,,E OF Af�VUCArvr_✓` .-e�- _�`- - '�~<�.._.--` DAZE"_ <br /> SIGNATURE OF RELEASING OFFICIAL__. . ----l�A f E�----.--_---.-- .. <br /> EH 00 14 (REV :)196I <br />