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I <br /> N S S TO 14087338386 P.02 <br /> P H A S E S �` <br /> P H A S E S �`" SAN JOAQUIN COUNTY <br /> IBLIC IIEALTII SERVICES <br /> )NMENTAL IIEALTII DIVISION <br /> Site Assessment Services ECORDS R LEASE APPLICATION <br /> David K. Wood <br /> Registered Luvirannreival AssessorO s �/L PHONE NO f�S) <br /> 355 W. Olive St.. Suite 108, Sunnyvale.CA 94086 0 11 ri <br /> (408)733-8384 Fax (408)733-8386 VRONE NO <br /> FILE ADDRESS MAD AGENCY �D I j_D TE <br /> E44ITr <br /> L C P <br /> o 20 �,o G•a �� e"1 a(o _ <br /> , - 5, M �fALTH <br /> Z�3z <br /> .� z 3 <br /> 2.13 I tl 1r ! + <br /> 00 <br /> iJ <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS 1DEN7IF#ED IN THE PUBLIC HEALTH <br /> SERVICFS/FAMRONMENTAL HEALTH DIVISION(END)P011CY #94-007,6RDINANCE CODE OF SAN <br /> JOAQUIN CbUNTY,. EHb FEES AND SERVICE CHARGE RESOLUTIONS, S'T'ATE WATER CODE, � <br /> GOVERNMETNT CODE AND THE EVIDENCE CODE. <br /> 1. A MJ <br /> AXINIUM OF TGN (14)PREMISE ADDRESM PER REQUEST, <br /> E' <br /> 2. PUBLIC F1LESIRECORDS REVIEW Is BY APPOINTMENT ONLY. APPOINTMENTS Arts ARRANGED BY <br /> CALLING-(209)468-W40. OFFICE HOURS FOR APPOIN-' MENTS ARE SCHEDULED MONDAY THRU. FRIDAY <br /> EXCLUDING HOLIDAYS, 8:00 Air To 12:00 NOON AND 1:00 PM TO 4:30 PM. <br /> 3. A 1't1;BLIC REC9RDS RELEASE APPLICATION (PRRA) I,4 REQUIRED. <br /> 4. PUBLIC PILPSIRECORDS NOT RmRNED IN wis sAmE CONDMON AS RECEIVED WILL BE CORRECTED <br /> BY THE EHD'iSTAPP AT THE EXPENSE OF THE APYLICANT. THIS ADDITIONAL SERVICE WILL BE BILLED TO THE <br /> APPUtCANT FOS! PAYmWr. (SEE EHD POLICY 94-007) <br /> S. OAIOINAL PUBLIC FILESIRECORDS SHALL NOT BE REMOVED TM THE EHD PREMISES" <br /> ` SIGNATURE?OF APPLICANT DATE Z / - Z - <br /> i . <br /> SIGNATURE!OF RlAlASINOi OFFICIAL DATE <br /> NO OHSIEI-ID RicbmsIFiLES ARE IDEN't1F w: <br /> DAM - Rrvrs�so m Nveoncana+ari0: - <br /> i <br /> PHSIERD ftCOPbS/F1LE9 EXISt ON THE ADDkESS(ES)NOTED. YOIJ 1K'ILL BE NOT1nim wHm <br /> RECORbstFill E$ARI:AvArLABtz FOR it£VETw: <br /> - DAM R1'! Nu+rnc►.no+MM <br /> E! <br /> TOTAL P.02 <br />