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y—G/—1 yyb 3:GJrl••i rn�r.�� ivi, cva .�.��r �,cv� � /' V� /L(i // <br /> SAN JOAQUIN COUNTY 9 <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DLVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT V�j � �1'T� 46. PHONE NO CISH` OW <br /> ADDRESS /0,- <br /> AGENCY NAME ONE NO-- <br /> ADDRESS <br /> FILE G <br /> ADDRESS LEAD AENCY DATI3 <br /> s <br /> 7If15 NOTICE IS SUBJECT TO TILE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAI.HEALTH DIVISION (EIID) POUCY/192-007, ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, EIID FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODH AND THE EVIDENCE CODE. <br /> 1. A MAXIMUM OF TEN (10) PREMISE ADDRESSES PER REQUEST. <br /> 2. PIIBIJC RLES/RECORDS REVIEW ARE BY APi'CII TM ENT ONLY. APPOINTMENTS ARE <br /> ARRANGED BY CALLING (209)468-0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY THRU FRIDAY FXCLIJDING 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 RELL•ASE APPLICATION AND A NON•REEUNDAIIl_Ie DEPOSI•P OF 578.00 <br /> IS REQUIRED, DEPOSITS WILL BE RETURNED TO '111E APPLICANT jr. Ti1L PILES/RX-CORDS ARE <br /> NOT AVAILABLE WITHIN THE CUSTODY OF THE END. <br /> 4. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. 'IHF BALANCE OF THE CHARGES ARE DUE AND PAYABLE PRIOR TO REVIEWING THE <br /> DOCUMENT(S)- <br /> 5. PUBLIC FILES/RECORDS 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 BILLED TO THE APPLICANT FOR PAYMENT- <br /> S. ORIDINAL PUBLIC FILESIRECORDS SHALL NOT BE REMOVED FROM THE F1iD PREMISES. <br /> SIGNATURE OF APPLICANT DATE ��� <br /> sIGNATURE OF RELEASING OFFICIAL DATE <br /> FII 00 14 (REV 12192) <br /> \NV <br />