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SAN JOAQUIN COUNTY v <br /> PUBLIC HEALTH SERVICES ` " ' <br /> F20UONN ENTAL HEALTH DIVISION <br /> PI TBLIC RECORDS RELEASE APPLICATION/ <br /> APPLICANT -4N E /7> PHONB NO (9l 6 � 36(; •/7110 X Y.?/ <br /> ADDRESS a F C/ <br /> AGENCY.NAME 'f, /A/C - PHONE NO a& 366_ -L2-0-1-- <br /> S A <br /> / 70,('c M <br /> 130 s. 0�oo,^, <br /> ELE ADDRESS LEAD AGE 4CY D�� <br /> Ten A co lot S. 41 it son <br /> �' M FGbD pca ue2 i$8I E• inge.u.£"T" 5`I"LlS7ac�raa1 <br /> too �_ F=2t✓ <br /> , Yf 4' o stY i wJ Co I>e b ,A i c v <br /> 77 . VAL-�M'G P ts{�,J E rk5 <br /> M. C ' -sS + SAN 19 c!-7 M i N t 2- Ay E <br /> "?IolzlL fs"DE.S 1 1514 E . SC<FT- Avg 1E <br /> AtrL.Porr::r wnjd �,vaE piTk -q42 N. -A)RPo2r' Wy <br /> rTc_rr>•t_t.-1 -7�clt41� 11114q E. CaJ4�1NC L <br /> �Ont-rai.t I f3�a5 - 11 1V G• 1-7 r <br /> jo e7 . ({o A qNE C. <br /> 16'64 C, CN AN nl&L <br /> =EW20 <br /> To r✓1 l�agla.rt, _. (7 38�• L� 'E'w�o►�t`,T-'' <br /> 2T c T•oaD �0�-10 t= tr'f�E✓►�o�vT" <br /> sr�N Sa"2v?Q cp • 1$10 NA Z���N <br /> THIS NOTICE ISCT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRO AL HEALTH DIVISION(EHD)POLICY#92.001,ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, ED <br /> FEES AND SERVICE CHARGE RESOLUTIONS, STATE ABATER CODE, <br /> GOVERNMENT CODE THE EVIDENCE CODE. <br /> 1. PUBLIC Fnxsf LECORDS REVIEW ARE BY A.PPQUITMENT ONLY• APPOQMAFNTS ARE <br /> ARRANGED BY CALLI 4G (209)468-0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY TMU FRM EXCLUDING HOLIDAYS, 8:00 A.M.TO 12:00 NOON AND 1:00 P.M. TO 4:30 <br /> P.M. <br /> 2. A PUBLIC RECORDS RELEASE APPLICATION AND A NO <br /> N-RFFUNDAl DEPOSIT OF$78.00 <br /> IS REQUIRED. DEPO S WELL,BE RETURNED TO THE APPLICANT IF THE FILES/RECORDS ARE <br /> NOT AVAILABLE wM IN THE CUSTODY OF THE EHD. <br /> 3. THE ABOVE IE ENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. THE BALANCE OF THE CHARGES ARE DUE AND PAYABLE W0%TO REVIEWING THE <br /> DOCUMENT(S). <br /> 4. PUBLIC FILES CORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY THE EHD STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL BE TO THE APPLICANT FOR PAYMENT. <br /> S. ORIGINAL PUB C FILES/RECORDS SHALL NOT BE REMOVED FROM THE EM PRp4SF-S. <br /> SIGNATURE OF APPLICANT - DATE 1/ <br /> SIGNATURE OF RELEA SING OFFICIAL DATE <br /> EH 00 14(REV 10/42) <br /> a�I <br /> t '8 �-E : I t 2610610 t wo( .:I. . <br />