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f <br /> SAN JOAQUIN COUNTY A14� 12-41 <br /> PUBLIC HEALTH SERVICES U <br /> j ENYMONMMEN'TAL HEALTH DIVISION I( tiu t <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT b2 � 'c� S �o-r !�S PHONE NQ��o4� `i -7 6- 1 b-2� <br /> ADDRESS S+e 12 toclL.f- CA 15-Z07 <br /> A(3ENCY NAME PHIm NO <br /> $;+e ADDRESS 5UC-M VCk -.00 N Rom <br /> .a <br /> FILE ADDRESS LEAD ACENC DST$ <br /> yrs,: CA <br /> r A <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUEIlC HEALTH <br /> SMVICHVM ViRONMENTALHEALTHDIVISION(EHD)POLICY092-007.ORDINANCECODEOFSAN <br /> JOAQUIN COUNTY, HHD FEES AND SMVICE CHARGE RBSOLUTIONS. SPATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1. A MAXIMUM OF 7EN(10)PRIMSE ADDRESSES PER REQUEST. <br /> i PUBLIC FILESMECORDS REVIEW ARE BY APPOIN7111m T ONLY APPOINTMENTS ARE <br /> ARRANGED BY CALLING M9N68at340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY THRU FRIDAY EXCLUDING HOLIDAYS, 5:00 A.M. TO 13:00 NOON AND 1:00 P.M. TO 4:30 <br /> P,M. <br /> 3. A PUBLIC RECORDS RELEASE AFFUCATION AND A UPS-RE.FUNDABL DEPOSIT OF S7&00 <br /> IS REQUIRED. DEPOSITS WILL BE RETURNED TO THE APPLICANT IF THE FILIISIRECORDS ARE <br /> NOT AVAILABLE WITHIN THE CUSTODY OF THE EHD. <br /> 4. THE ABOVE IDENIIFIRD DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. THE BALANCE OF THE CHARGES ARE DUE AND PAYABLE MI Q$TO REVIEWING THE <br /> DOCUMENT(S)- <br /> 5. PUBLIC FILBSIRSCGRDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL B13 <br /> CORRECTED BY THE ERD STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL.Bfl BILLED TO 110 APPLICANT FOR PAYMENT. <br /> 6. ORIGINAL PURUC FILL RECORDS SHALL NOT BE REMOVED FROM THE IIID PREMISES. <br /> SIGNATURE OF AFFUCAN-r - DATE <br /> SIGNATURE OF RELEASING GPFICIAL DATE <br /> EH 00 14 (REV 17197) <br />