Laserfiche WebLink
sArr JQAQUIN catrxTY <br />MUIC HEALTH SERVICES <br />YNVIIRONmENTAL HEALTH DIVL4IoN <br />FURLiC RECORDS SSE APPLICATION <br />APPLICANT jLjtts. YekLck£F�: -- SSE PHONE NO �7 b - b$S <br />ADDRESS 40o WL.SaeJ Ste, Fjco%; CP- <br />AGFINCY NAME PHONE NO <br />ADDS <br />EUM ADP RE <br />n l .Lf— C, Z35 <br />7 ZT 15. Sr. <br />ccmiil Smop V604v^ <br />Leto� : <br />LEAD AGENCY DATE <br />s,w c,'7*To?9• - 26-74 <br />r <br />THUS NOTICE IS S[ RMCT TD TIB REQMndE V'TS IDENTWMD IN THE PUBLIC HEALTH <br />SERVICESIO IRONMENTAI. HEALTH DMStON (EHD) POL]CX M -M7, ORDINANCE CODE OF SAN <br />JOAQUNN COUNTY, EFID Nis AND SERVICE CFIARG14 7tE.�X.[TII02V5, STATE WATER CODE, <br />GOVERNMENT CODE AND TETE .EPIVENCE 00DE. <br />1. PUBLIC FULES XCORDS REVIIIW An By AEC929 iuFM ONLY. AFFOINThMgTS ARB <br />A411MUM BY CALLING (209}I69- 340. OFFICE iIOURS FOR APN'UUtIV'Ihflq 'IS ARE SCHFMUI UD <br />MONDAY 11MU LWAY EXCLUitNG HOLIDAYS. 8:40 A.M_ To 1100 NOON AND 1:40 P.M. TO 4:30 <br />2. A PUBLIC RECORDS RW i, APPLICATION ANI) A NON-RFPUNDABLIl DBPOSIT OF $78.00 <br />IS REQUIRED. DEPOSITS WILL, BE RUMRNED To TIM APFUCANT IF TIRE FIT.ESI WCORDS ARE <br />NOT AVAIIARLS 'WIT" UM CIISPDDY OP 'IRB EM_ <br />3: TI113 ABOVE IDENTIFIED DEPOSIT is A"LIED TOWAIRDs THE ToT'AL FILE RtV FEE <br />CHARGE. THE BALANCE OF TTM CHARrym ARH DuE AND PAYABLE MOR To R&VIEWIlYG THE <br />DOt'UM$NI(s). <br />` , PUBLIC FIIlMMUCGRDS NUT RL•TURN+TRD IN THE SA14+NE CONDITION AS RECEIVED WILL BE <br />C17NiRE=D BY THE EHD STAI+F AT THE egg OF 11M APPLICANT_ TM9 ADDITLONAL <br />SERVICE Wn L BE MUM To THE AFFLIC1bW FOR PAYMENT. <br />5. ORIGINAI- PtJBUC Fg-FS11tF.CORDS SHALL NOT HE RP -MOVED FROM THE EM PREWSES, <br />SIGNATURE OF AFFUCANT til DATE <br />SIGNATURE OF RELEASING OFFICIAL bATF <br />ER 00 14 (REV 10!92) <br />n ^ .-40 SEF 2 6 1ggq <br />