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SAN JOA UTN COUNTY z <br /> MLIC EMALT11 SERVICES <br /> WMONMENTAL HEALTH DIVSION <br /> PURUC RECORDS SASE AM ICATIoN - <br /> APPLICANT s VALcge FF-- SSE PHONE NO -'5-7 0 4$S—4bS3 <br /> ADDRESS Maga N-EL-Satf 44E. sem.-v 1Jcot CPQ 9 4�' qz:, <br /> AGENCY NAME PMONE NO <br /> ADDIS <br /> ELE.ADDRM LEAD AgEINCY <br /> � . r- _ . .�..,.J ���r.o4• DATB <br /> �; <br /> 2&-`T4 <br /> 8►l S.c.., <br /> Q C�'1.,dc'a -�?►�. s���9r C,a2.11101L 9 ftM&2r <br /> r .+ 235 <br /> Lags f.,c.�IZt $.Cen�y SI <br /> hag comob w- <br /> � 117erat'�7'r�tlG�,`neS�3�(Da 111r�tb� St <br /> r <br /> THIS NaHCE IS SIJRIBCT To TIM REQTIIR mflmS mgmnTFMD IN TFIE PUBLIC HEALTH <br /> 9MVICESIENVIR0NMENTALMiALTH DTVI9tON'(EM)POLICY -007,ORDINANCE CODE OF SAN <br /> JOAQUIN COUN'T'Y, IIID PIMS AND SERVICE OMRG13 RESOIAMONS. STATE WATER CODE, <br /> GOVERMaNT CODE AND THE EVIDENCE CODE <br /> 1. PUBLIC FILES4MCORDS REVIEW ARE BY Megnfliflm QNLX- APFOINnHXrS ARE <br /> ARRANGED BY CALLINQ (7A9 -0340. OMCE HOURS FOR A"UMTMEIM ARE SCnMULFD <br /> MONDAY TIMU MIDAY EXCLiR)MG HOLIDAYS.8:00 A-M-TU 600 NOON AND 1:00 P.M.TO 4:30 <br /> P.M. <br /> Z A PUBLIC RECORDS RZXASE APPLIC'AM ON AND A NQH-RFU AUX DEPOSIT OF$78.00 <br /> IS REQUfflED. DEPOSff5 WU-L BE REJURNED TO TIM APPLICANT IF THE FUMSIR iCORDS ARE <br /> NOT AVAILABLE WITHIN MM COSMDY OF TRH IND_ <br /> 3: TIM ABOVE IDENIUMM 138E+0SIT IS APPLIED TOWARDS nffl 'TOTAL FIIE REVIEW FEE <br /> CHARGE. UM BALANCE OF TRE CHARGIN ARE DUE AND PAYAW-E PLU TO REVM-WING THE <br /> DOCUMENT(S). <br /> 4, PUBLIC FILESMECORDS NOTREIURNM IN TAE SAPAIS CONDITION AS R19CEIVED WILL,BE <br /> CCJIiRECTPD BY TUB END STAFF AT THE EMME OF THE APPLICANT. IMS ADDITIONAL <br /> SEPIVICE WILL BE BTLLM TO THE AFFLICANT ICOR PAYMENT. <br /> �-. <br /> 3. ORIGINAL PUBLIC Fg-ESIRECORDS 3jfAIL NOT Bfi REMOVED FROM THE EHD VREWS1?:S. <br /> SIGNATURE OF APPi7CANT DATE -`� �y <br /> SIGNATURE OF RELEASING OFMCIAL DATE <br /> ER 00 14(REV 10/92) <br /> 51 --elv SEF 2 6 199 <br /> �.l f1 x111 l.nn 'n.1T !1l`I!f n-rnn nnn nrn17 n� Inn >:O rn7 ion <br />