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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONN ENTAL HEALTH DIVLSION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPISCANT ja ,�v {W 1x b - PHONE NO al�/ y q-3 S't o <br /> ADDRESS_LRZR T'1,,t,- ✓LI S :� <br /> AGENCY NAME PHONE NO <br /> ADDRESS <br /> ETU� S LEAD AGENCY pATg <br /> lion bl, 11-ex t <br /> +&D N1. r- rr r+ <br /> S - z1wH /SIT — <br /> frw�lfa <br /> l��D nl 1 f 5-1 <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION(EHD)POLICY#92-007, 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 /> 2. PUBLIC FILES/RECORDS REVIEW ARE BY APPOINTMENT ONLY. APPOINTMENTS ARE <br /> ARRANGED BY CALLING (209)468-0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 A.M. 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 OF$78.00 <br /> IS REQUIRED. DEPOSITS WILL BE RETURNED TO THE APPLICANT IF THE FILES/RECORDS ARE <br /> NOT AVAILABLE WITHIN THE CUSTODY OF THE EHD. <br /> 4. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL PILE REVIEW FEE <br /> CHARGE. THE BALANCE OF THE CHARGES ARE DUE AND PAYABLE PRIOR TO REVIEWING TILE <br /> DOCUMENT(S). <br /> 5. PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRHCT$D By THE EHD STAIT AT THE EXPENSE OF 71M APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT, <br /> 6• ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE EHD FREMISES. <br /> SIGNATURE OF APPLICANT <br /> SIGNATURE OF RELEASING OFFICIAL DATE J <br /> EH 00 14 (REV 12/92) <br />