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J�II 00 I4 (REV 5194) SAN JOAQUiN COUNTY J 12-ZI <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH LIMSION <br /> PUBLIC RECORDS RELEASE APPLICATION ` <br /> APPLICANT �� CLI PHONE NO `i <br /> AQDRF�SS F L{ --4-e`8Z <br /> AGENCY NAME pvsctv Lo. PHONE NO <br /> ADDRESS <br /> sl+DcK+c , CA 95 29 9 <br /> ' 5 <br /> I <br /> FILE ADDRESS LEAD AGENCY DATA <br /> y�.F� Y <br /> a f-\"(CC> I�l ;?_Lb ul 1-( <br /> nusS _�E; (aZF)W . CI�aY�el��ay L <br /> a CctiSG0 :; •�ta, 7�J9 E.c6v'-kr\'tkjY L op 15'---Z.4 <br /> 3)eycon" • EI DoruLao L op -3sz�_ rc„'--0— a -z _Q 2- <br /> IC <br /> IC ons L 165 S . fora -- LCA (� 4` �� b -Zi -9L <br /> f <br /> THIS NOTICE IS SI-WECT TO THE REQUIRFNIEN'('S IDEN-nFIED IN THS PUBLIC HEALTH <br /> SFRVICES/E= VIRONMENTAL HEALTH DIVISION (EHD) POLICY #94-007, ORDINANCE COVE OF SAN <br /> J0iv?UJN COUNTY. EHO FEES AND SERVICE CHARGE RFSOLUMNS, STATE RATER CODE, <br /> (;OvERNINIENT CODE AND 7'HE EVIDENCE CODE. <br /> I. A MAXIMUM OF-TEN (10) PEZEMISF ADDRFSS&S .PFR RBQUEST. <br /> 2. PUBLIC FiLES/RECORDS REVIEW Is BY P O APPOINTNIENTS ARE ARRANGED BY <br /> CALLING '-(209)468-0340. OFFICE }IOUit5 FOR AppowTMENT9 AM; SC}fE DVLE4 hIONDAY TElRU FRlDAt' <br /> C-XCI,EJDING'HOLIDAYS, 6:00 AM TO 12,00 NOON AND-1:00 PM To 4:30 Pm.. <br /> 3. A Puduc R&CORDS RP-LEASs APPLICATION (PRRA) IS REQUIRED, <br /> 4 Mal-IC FILES/RECORDS NOT RSTURNGD IN TI}E,5AME CONDITION AS RSCEIVED WILL BIi CORSiCCTr-D <br /> BY THE EHD STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL SERVICE WILL BE BILLED TO TILE <br /> APPLICANT FOR PAYhtF,I+IT. (SFE EHD POLICY 94.007) <br /> 5. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED I=RON4 THE EHD PREMISES. _ <br /> `iI(;NATl3F'F OF APPLICANT DATE <br /> SIGNATURE or RELEnSING Orr-ECTAL DATE <br /> i <br /> Not PHSIOID RECORDS/FILES ARE IDENTIFIED: <br /> t,,•, A.,...u.vn a,: N.rns,Gtw+-A.r=• . <br /> Y PHS/EHD RP-CORDS/FILES RXIST ON TIIE ADDRESS(ES) NOTED. YOU WILL BE NOTIF-LED WHM i <br /> RECORDS/FILES ARE AVAILABLE FOR REVIEW: <br /> p, hsnnnr.n—MTe: <br /> ij <br /> y� <br />