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P0 A-l-41Qtx.. (1 `1�7 " <br /> lJ 314 L-) <br /> SAN JOAQUIN COUNTY <br /> MBLIC HEALTH SERVICES / iti' <br /> VNVIRONMF,NTAL IIEALTII DIVISION --��a �, <br /> PUflLIC RECORDS I?tFJ EASE AppLiCATION 4 <br /> APPLICANT- t1a PHONE No <br /> ADDRESS <br /> AGENCY NAME <br /> MOVE N �� <br /> ADDRESS <br /> OLE APPRMS I I�aD A�1�NJCY pA <br /> THIS NOTICE IS SUBJECT TO T1IE REQUIREMENTS IDENT11710) IN 114E PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL 14VALW DIVISION{E1IU)POLICY A92 007,ORI.)INANcE CODE OF SAN <br /> JOAQUIN COUNTY, EHD F1r1=S AND SERVICE CHARGE RESOLUTIONS, STATE WATER. CODE. <br /> Oo`VERRNMIiNT coDE AND'TNB EVIDENCE CODE. <br /> 1. A MAXIMUM OF TEN (10)PREMISE ADDRESSES PLIC REQUEST. <br /> 2. PUBLIC FILESIRECORDS REVIEW ARE BY AeEp-j VTMI3NT ONLY. APK)INTNIFNTS ARE <br /> ARRANGED BY CALL-iNG (-209)468-0340. OFFICE HOURS FOR APPOINTMEN'T'S ARF SCHEDULED <br /> MONDAY IHRU FRIDAY CCL.UDIN(i HOLIDAYS, 8:40 A.M. TO 12:00 NOON AND 1:40 P.M. TO 4:30 <br /> P.M. <br /> i <br /> 3. A PUBLIC RECORDS RELEASE APPLICA1 ON AND A NON-RFFUNDA111,F DEPOSIT OF$78.{x1 <br /> 1S REtZU1It.Ei). DEPOSI"I-S WILL BE F-ET IRNED TT7 <br /> O THE APPLICANT iF iE FILES/RECORDS ARE <br /> { PFOT AVAILABLE WITHIN THE CUSTODY OF THE BED. <br /> 4. THE ABOVE iDENT1F11i1) D1✓POSI'T IS APPLIED TOWARDS '"1E TOTAL FILE REVIEW FEE <br /> (;1 ARAE. THE BALANCE OF THE CHARGESARF DUE ANI) PAYABLE Pit1QR TO REVIEWING THE <br /> UocumsNT{S). <br /> S, PUBLIC FILES/RECORDS Nor RETURNED IN INE SAME CONDITION AS RECEIVED WILL BE <br /> COB1tECC1?U gy THE EiII7 STAFF AT THI- EXPENSE OF T1113 APPLICANT. <br /> PHIS Ai�DITIDNAL <br /> j SFRVICH WILL BE BILL,-o TO THE APPLICANT FOR PAYMENT <br /> b. ORIGINAL PUBLIC F1LF-SiRECORDS SHALL NOT BE REMOVED FROM'lHE -11U PREMISE;• <br /> SIGNATURE OF APPLICANT /ri Is��»m ���� IyA IE <br /> SioNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14 (R6V 12192) <br /> �/.2 3/95 <br />