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e- <br /> *-0' SAN JOAQUIN COUNTY 'rr� <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVYSION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APICAN'T a ,J NO PHC7NB (elle) 6 <br /> 9�i -357 U <br /> ADDRESS oa T vTt= .D #101 LRRM�r�1T0 9 gl ` <br /> AGENCY NAME rN „P <br /> ADDRESS rJ (, PHONE NO�r� <br /> EMS ADDRESS LEAD AGENCY p <br /> X107' r <br /> Crs = <br /> Lop 3 it1 (149 9Z <br /> ! r� -`- 15 H NorisT1- <br /> THIS NOTICE I3 nTwECT TO THE REQUaUa4ENTs IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION(EIID)POLICY#92-007, ORDINANCE CODE OF SAIN <br /> JOAQUIN COUNTY, MD FEES AND SERVICE CHARGE RESOLUTIONS, STA'R'E WATER CODE, <br /> GOvERNbmy-T CODE AND THE EVIDENCE CODE. <br /> 1. A MAMMUM OF TEN(10) PREMISE ADDRESSES PER REQUMb .. <br /> 2. PUBLIC FILES/RECORDS REVIEW ARE BY . APPOINTMENTS ARE <br /> ARRAN13BD BY CAI-UNCI (209)468-0340. OFFICE HOURS FOR APPOINTMENTS ARB SCHEDULED <br /> MONDAY THRU MMAY EXCLUDING HOtIDAY9, 8:00 A.H. TO 12:00 NOON AND 1-.W P.11t. TO 4:30 <br /> P.M. <br /> 3. A PUBLIC RECORDS RELEASE APPLICA77ON AND A NON- AM DEPOSIT OF 578.00,,• <br /> IS REQUIRED. DEPOSITS WILL BE RETURNED TO THE AP'iE ANT IP THE FILBS/R&CORDS ARE <br /> NOT AVAILABLE WnHW THE CUSTODY OF THE a3D. <br /> 4. TIM ABOVE IDENTIFIED DEPOsFT IS Appy= TOWARDS THE TOTAL PILE REVIEW FES <br /> CHARGE. THE BALANC$OF THE-CHARGES ARE DUB AND PAYABLE $jQ TO REVIEWING TSE <br /> DOCUI EPMS). <br /> 5- PUBLIC FM S/RECORDS NOT RETURNED 1N THE SAME CONDITION AS RECEVFD WILL BE <br /> CORR.B= BY THS EM STAFF AT THE EXP'tiNSB OF THE APPLICANT. TIUS ADDMONAL <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. , <br /> 6. ORIGINAL PUBLIC PILES/RECORDS SHALL NOT BE REMOVW FROM TSB FRD PREMISES. <br /> SIGNATURE OF APPLICANT + .JJc• DATE —Q�Z1,���_� <br /> SIGNATURE OF RELEASING OFFICIAL <br /> 1� RR CO 14 (REV 12/92) DATE <br /> re'.J. C1r+nrq�r]rjT�r n r <br /> r rn..IJ rcC <br />