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11/24/1997 14:32 2995932556-' C-BAPf,15Tf ENVIP04404 ' SAGE 02 <br /> 23=1597 '02.57M FRm TO 5332SS6 P.01-� <br /> SAN JOAQUIfT COLWry <br /> PUBLIC HBALTH SERVICES <br /> RWIROM4ENTAL HEALTH DIVISION . <br /> ! PUBLIC RECORDS REL•SA. N APPLZCATZON <br /> (` �� <br /> APPLICANT v c e PHONE NO <br /> ADDRESS c t�_Ste-r- So -cA__ <br /> AGENCY NAME <br /> l►bD ESS ... . ........._PHONE NO <br /> - � 1rJ�rlc�ar�r�ft,e`�gi��tstf#,rxtr�sw•*�,•:t,r.itirxt*+�,rrrwtt(�ti�tt*rii***�.�t�t,rw,r <br /> wY�Nty{ '^ 'r•..`• bLY SZsEfL.S i~" .+.,^,` Y]�fl��^,_I3�]y► 11p <br /> }* ��i,� :ac.�. ; '•;•.. "~►+! ti� <br /> E. F I1 <br /> 1YW#•R�lit#ittiiv:+•r1•�y•!i(*�wta�# i• ,14�*tri. • ,.-•l xstirr'rty'(r##tt tilt##1t•t•k <br /> qjrLA <br /> Jo <br /> f <br /> THIS $10TICE IS SUejEC r TQ rNE RFOtJIREMFNTS ;�7ENT►FtE;; r-'l rHE Puet_iC HEALTH <br /> SERVACES'ENVIftOfYMEPJTAL HFALrH re VISION EE 4-1 PCNLK-Y 994.007. ORDINANCE CODE-OF <br /> SAN JOAOUIN COUNTY, F-H4 FEE AND SEptIICF CMASC ' F.ESt?!.UTIONS, STATE WATER CODE, <br /> GOVIONMENT CODE ANO THE EV'DENCE CODE. <br /> i <br /> 1. A MAXIMUM OF M J"Q PREMISE ADORf:SSES PER REC7UE-Sr <br /> 3, PUJLIC FlfrES1RPC[?R05 F VIt W 15 E3Y APPOWINENY ONLY- APPOINTMENT'S ARE PROCESS- <br /> ED 6YI CALUNG 13091U-3420, OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> THRUORIOAY EXCLUDING HOUDAYS, 8:00 AM TO 12.:OQ .NOON AND t:0010 4:30 PM. _ <br /> 3. A 11UIIUC i0kn/RECORDS RELEASE APPLICATION IPRRA) IS REQUIRgp, <br /> 4 PU C FUSMECORDS NOT RETURNED IN.TFrE SAME CONDITION AS RECEIVEra WELL 13E <br /> a i CORR BY�f{E.EHD STAFF AT THE EXP9N8E OF THE APPLICANT. TMS ADDITIONAL' <br /> !Q E APPLICANT FOR PAYMENT. (SEE EMD pOUCY 94-007) _ <br /> .::+Fy K: }• .,,, . ,• C•LIJr[DI SHALL NOT Be REMOVED FROM THE i=I•IO PREMISES, •"•'�_ <br /> t l...F <br /> _ - ••I: •7wi� ,*�ilwrrwfwwww•#• #• •w��a •• •���s��� .� ♦ww• •yf• w��llww�l+ I •„e <br /> ` <br /> SIGNA MM <br /> OP APPLJCANT DATE <br /> 1. <br /> SIGNAhME OF RELEASING OFFICIAL DATE <br /> EH Od 14 (REV 91961 <br /> tc�•. <br />