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%ivLl <br /> tu.�ltsrnl:uCn �trc." -�t UUl <br /> TO ".i1 94130G21 P.82 <br /> es-moi-i 99e le:�'I FR3, n , <br /> , <br /> 9fl`�y3 <br /> • SAN JOAoUIN COUNTY <br /> PVBLIC HEALTH SURV'1CSS <br /> ENVIRONMI314TAL" 11SALT11 pTYI9x0N <br /> PUBLIC nECORDS RELEASE APPLICATION <br /> Ai�pL1r�NT <br /> ADOR Sm? _. <br /> AG�?N NAHE PHONE i 0 <br /> ADPR 5 <br /> *4k* amigmss NAME/-err+ert�es�rt*ttt#+rtffkrt,a*t,o- t+##+tMrwetir#rsaa*t ati+rxyeitt�rrwr4t#*�F <br /> PROGRAM O$ <br /> TXT_ ZU <br /> r:� iYL�/sem <br /> F� <br /> Cor 73C <br /> t <br /> •��iw w*,r,rff*�i*s*ar*,rt,rrtt*t*•:t•rtsi�f#xw!#*#+4•t*tr�rr*.r,r+s#,r*t++•r <br /> THIS NO CE 15 SU@.JECT TO THE RE0111AEMENTS IOENTinED iN THE PUBLIC HEALTH <br /> SERI ICS /ENVIRONMENTAL HEALTH DIVISION IPHDI POIJCY #94-007, OROINANCE CODE OF <br /> SA JO OWN COUNTY, EHD FEE AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE. <br /> -� C0De-A-N0 THE-eVtDENC9-000E- - <br /> 1 <br /> 1._d MAXIMUM OFA 11911_PREMISE ADDRESSES PER REQUEST <br /> 2. p; SLJC I`ILES7REC0RDS REVIEW IS BY APeOINjENTT OJILY. APPOINTMENTS ARE PROCESS- <br /> ED e,Y CALLING F2091468-3420_ bFHcrm NOUNS FOR APPOINTMENTS ARE SCHEDULI:O MONDAY <br /> THRO M DAY EXCLUDING HOLIDAYS. 8:00 AM TO 12:00 NOON AND 1 ao0 TO 4:34 PM. <br /> 3. AI puE uc HLES/RaccRb5 ReLEASE APPLIC.%TlON MARAI IS R9QUIRED. <br /> 4. PUBLI IffILESIRECORDS NOT RETVRNED IN THI+ SAma CONOI7ION AS RECF]VED WILL BE <br /> COR4EG EIS BY THE EH0 STRPF AT THE EXPENSE OF THE APPLICANT_ THIS ADDITIONAL <br /> sen'410EMALL 08 BILLED TO THE APPLICANT FOR PAYMENT. ISRE EHD POLICY 94- 007) <br /> , <br /> 5. OAIGII IAL PUBLIC M&SIRECORDS SHALL. NOT 9E RLwMOVED FROM THE EMD PREMISES. <br /> •r .I-..• r1}�}y}s•r•.��♦ rrrr•t}. .-�• s._.rr---..r-------.._---q*msa-r.r <br /> SIGNAT E OF APPLICA DATE_f—J 5L-2fsL <br /> SIGNATU E OF RELEASING OFFICIAL DATE <br /> EH Oa 14 REV 91$61 <br /> TOTAL P.02 <br />