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' I <br /> II <br /> Ell OO 14 (REW 5/94) SAN JOAQUIN COUNTY <br /> I'U4tl,1C III;AI;I'I1 SEILVICI+.S I/...-¢A <br /> 1{,NVLlt0NMJ,',NTA1, IIKAI;Tll DIVISION WSJ <br /> I'UIILIC ILI;COILllS R11-,LLASL APPLICATION <br /> I\1'4'1_IC/�N'1' I' �k) <br /> IlON1- No -1 -� cj/ �' c- <br /> ADDRESS <br /> AGENCY NAME CIV Z 141-)14- oC r ,fI PHONE- NO <br /> ADDRESS <br /> FILE ADDRESS LEAD AGENCY DATE <br /> -VO <br /> aI,' � L(f j �lt 3Sa7 L <br /> i ry I 0 a rr� v A , C r <br /> Pf4L <br /> p <br /> 10 1 Lt <br /> N �� n•� cC > r r <br /> 'I-I,Is NO-I-ICU IS SU13 ucr 'TO 'I'I111 RUQUIREMUNTS IDENTIFIED IN TML PUBLIC 1IEAI:1-11 <br /> SERVICFS/ENVIRONMENTAL IIEALTII DIVISION (1:11D) POLICY !l94-007, ORDINANCE CODE O1'SAN' <br /> JOnQU1N COUNTY, L'11D I EE5 AND SERVICE cIIARGI: RESOLUTIONS, STATE WATER CODE, <br /> GOVURNMENT CODE AND THE EVIDENCE CODE. <br /> L A MAXIMUM Or '1'1:14 (I()) PRUMISH ADDRESSt?S PCR REQUEs.1% <br /> 2. PUnLIc FILES/RECOI1D5 REVIEW is nY APPO[NTME r ONLY. APPOIN'I'mr ,, :s ARE ARRAN(IEU nY <br /> CALLING (209)468-0340. Orrirn iiot)PS FOR A111"INTAIFNTS AR1i SCHEDULED MONDAY TIIRtI, FRIDAY <br /> EXCLUDING HOLIDAYS, 8:00 AM To 12:00 NOON AND 1:00 Pnt ro 4:30 mt. <br /> 3. A PUBLIC RECORDS 11MRASE APPLICA'1-ION (PRRA) IS REQUIRED. <br /> 4. Punuc I'II.ES/1111-CORDS NOT RIi11U11NED IN THIS SAME coNDrrION As RECEIVED WILL Uri CORREC I'1:1) <br /> ny -rim EI-ID STAFr% AT TILE uIlr-N.96 Or; l'l1E APPLICANT. ` IIIS ADDrI'IONAL SERVICE WILL im. IJILLED TO TI IE <br /> APPLICANT FOR PAYMEN-r. (SEE EIID POLICY 944)07) <br /> 5. ORIGINAL PUBLIC PILLS/RECORDS SHALL NO'r 011 REMOVED FROM -1-II6'U11D i'REMISr s. <br /> SIGNA'rU[2E OF APPLICANT DAT <br /> SIGNATURE;OI- RrLII-ASINO 0F1'ICIAIL DATE <br /> No PIIS/UIID RECORDS/I'll-mss ARE iDENTH--IED: <br /> Ititi me Rmnrrvveen�n PNARGAmMi.]9191 <br /> I'I-IS/I:IED RECORDS/FILES EXIST ON TI 111 ADDREss(r,S) NOri,m). YOU WILL HE No-ri ia) WIiEN <br /> Itrc )RbS/Fux,S AR[; AVAiLAB1,1: rOR Itf Viim <br /> I}nrne Rm9mam9 rre MMM-AMM D911M - <br /> I <br />