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SAN JOAQUIN COUNTY <br /> PUBLIC HEAL'i'll SETIVICiTS <br /> ENVIRONMENi'AL IIF,AI,I'lI DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> hAPPLICANT �rc,(,e M4� /D�lv�r���E�Gr c PRONE NO 2,,),?- iqS(- 92oo <br /> ADDRESS _ d, �'AX Z�� St�oc�r4�H C,* 4s z.rJ/3oLo <br /> AGENCY NAME PHONE NO <br /> ADDRESS <br /> TILE ADDRESS LEAD AGENCY DATE <br /> LZL 1Y. jv/� K1� Cj'rcrJ1'1--.;, IRFG <br /> x`12 4 F. `i11r'N.az _ e l"/cls r�.fc ':;z,r�4 <br /> 4S m *'1 we C t_Al off ' f er <br /> I/G u0 Z Z-.- u <br /> to l � �. C4Y Lilt,P/ 7�_ � 7P��• /1"JCf nC� <br /> J��1—�. ��,4 N�f 1 I S� /�/ /�. (�-�C I/,• T vl,t`N a� _ <br /> I_1(00 1410 r -C4/ de v4o4 <br /> G Z/ • !/hr'n z-,- v-cNC, n C t <br /> TATS NOTTCF iS SUR1ECf TO 1.1111 REQUIREMEN-I'S iDEN'i1P1ED IN 'i'!IE PUBLIC HEALTH <br /> SERVICES/FNViRONMFN-rAL 11FAL-111 DIVISION (F-14D) POLICY{1924X07, ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, EMD FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE_. <br /> s , <br /> I. A MAXIMUM OFTEN (10) PREMISE ADDRESSES PER REQUES'r. <br /> 2. PUBLIC FIL,FS/RECORDS REVIEW ARE BY APPOINTMENT ONLY. APPOINTMENTS ARE <br /> ARRANGED BY CALLING (209)468-0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY TTIRU 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 RELEASF APPLICA'T'ION AND A NON-REFUNDABLE DEPOSIT OF$78.00 <br /> IS Ri:QUIRFD. DEPOSITS WILL BE RETTIRNED TO THE APPLICANT iF THE FiLES/RECORDS ARE <br /> NOT AVAILARI,F WITHIN T11F CUSTODY OF TTIE EHD. <br /> 4. THE ABOVE IDENTIFIED DEPOSIT iS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> (IIARGE. 111F BALANCE OF THE CHARGES ARE DUE AND PAYABLE PRIOR 1-0 REVIEWING THE <br /> DOCUMENT(S). <br /> 5. PUBLIC: FLLFS/RECORDS NOT RETURNED iN TTIE SAME CONDITION AS RECEIVED WiLL BE <br /> CORRECTED BY THE EIID STAFF AT TTIE EXPENSE OF 111E APPLICANT. THiS ADDITIONAL <br /> SERVICE WIi,L BF BILLED TO 'TTIE APPLICANT FOR PAYMENT. <br /> 6. ORIGINAL. PUBLIC FiLES/RFCORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> a SIGNATURE OF APPLiCAN'r� .`�) / :r, DATE <br /> Y - <br /> Sl(;NA'11IR1-.OF RFi.EASiNG OFFICIAL` Dn'T'F <br /> r:1I 00 14 (REV 12/92) - - -- - - <br />