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Q 3 <br /> SAN JOAQUIN COUNTY �- <br /> PUBLIC IIEALTII SERVICES ��` V <br /> FNVIRONAIENTAL HEALTH DIVISION ' <br /> PTJBLIC RECORDS RELEASE APPLICATION <br /> APPC.YCANT w, LIQ 4 PHONE NO ' 45 <br /> ADDRESS ! ,SG -e- -� <br /> AGENCY NAME — 1.5(_ PHHONB N <br /> ADDRESS <br /> PJLE A.DPMS =1) A !INCY � <br /> .17 <br /> THIS NOTICE IS SUBJECT TO T11E REQUIREMENTS IDENTIFIF-13 IN TiIE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL 14GALTII DIVISION(Ei10)POLICY A'92-007,ORINNANCG CODE OF SAN <br /> JOAQUIN COUNTY, EHD FIRI=S AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE- <br /> 1. A MAXIMUM OF TEN(10)PREMISE ADDRESSES PER REQUEST. v, <br /> 2. PUBLIC FILES/RECORDS REVIEW ARE BY APPOINTMENT ONLY. APPOINTINFNTS ARE <br /> ARRANGER BY CALLING (109)468-0340. OFFICIi HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> t MONDAY'IHRU L'RIDAY EXCLUDING HOLIDAYS, 8.00 A.M. TO 12:00 NOON AND 1:04 P.M. TO 4:30 <br /> 3 <br /> 3. A PUBLIC RECORDS RELEASE APPLICATION ANDA NON-RF_FUNDA111,F DI7!POSIT OF$78.(10 <br /> IS REQULR.ED. DEPOSITS WILL BE RETURNED'TO THE APPLICANT IF"CINE i%ILES/RECORDS ARE <br /> - i NOT AVAILABLE WITHIN THE CUSTODY OF THE BHD. <br /> I 4. THE ABOVE IDENTII'Ii:L) DF-POSIT IS APPLIED TOWA•RPS 'n{E TOTAL FILE REVIEW F <br /> i CHA.RUE. THE BALANCE OF THE CHARGES ARE DUE AND PAYABLE PRIOR TO REVIEWING THE <br /> DOCUMENT(S). <br /> S. PiJpLIC F7L.ES/RF('OKUS Nur RE`MRNBI3 IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY THE F--HD STAFF AT THE EXPENSE OF THE APPLICANT. "PHIS ADDITIONAL <br /> SF <br /> RvICF WII.1.BE BILLED TO THE APPLICANT FOR PAYMENT. <br /> 6. ORIGINAL PUBLIC FILLS/RECORDS SHALL NOT BE REMOVED i=RVM"1IiE GIIU!'REMISES. <br /> SIGNATURE OF API>UCANT /�/ j� ., 6ATE <br /> E <br /> SioNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14(RBV 12/92) <br /> i <br /> 9/.23/r1 - <br />