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J I'I1Ifl GIVViRUIYfILIYInL' -IL ILG - UVJ •+I � cavv - "Ilr. v•` 'r ++ ...- 1� •vva .va <br /> V V <br /> j„ Ax,� <br /> SAN JOA )UIN COUNTY <br /> PU9LIC HSALTki SERVIC" <br /> SNVIRONMSNTAL HEALTH DIVISION <br /> PUHLIC RECORDS R81-BASE APPLICATION 9 <br /> PHO <br /> pPPF�ICANT /J `^ <br /> �e u� CA N 9SS L4Q 5 <br /> ADD�trzgs_, 17�a.O f PHONE NO <br /> AOE CY NAMB SSoC�ta <br /> ApDt~t�'`3E <br /> yfytf <br /> #r«t«t+«+x+rx+tt+tywtxi irti+it#i*{Ittx.t#iii*+tiiwi#tiitttit++tt <br /> g3JLL � ' fiU51'NS(NzRvvs,- OF—F.SLS <br /> �ACILIT'S -f•� <br /> GV�f 5 YU <br /> Q O E 1'lner v� 06 G _ <br /> >r <br /> ------------ <br /> I <br /> i <br /> i <br /> iii'�**tt,kr+tt+txtit«yx'xY1[xx#Ytxxxx><t>t4� ♦ • tLM 1rt'ft+♦+ilii««iWYt«At• <br /> T11SINOTICE IS SUBJEIr f I U I Ht HEGU1REMCPIT3 IDlNTIFIED IN YHL' PU RDI HEALTH <br /> SER CES/ENVIRONMENTAL HEALTH DIVISION (EHDI POLICY OLUT, 7, ORDINANCE CODE OP <br /> GOVSANERNMENT CODE AND THE EVIDENCE C OAQUIN COUNTY EHO FEE AND 'Ct: CHARGE RESOLUTIONS. gTATt'WATER CODE, <br /> i. AiMAXIMUM OF 1L! PREMISE ADDRESSES PER REQUEST <br /> Y. APPOINTMENTS ARE pROCE55- <br /> Z, P�IBLIC FILESIRECORDS REVIEW tS BY AEMN?�1APPOINTMENTS E LM'- -- <br /> TD By CALNG 1209KFRID 11' EXCLUDING OUOaYSC 8:04 AM TO 12:00 fl0 NOON AND 1ROO TO 4:30 PM. <br /> MONUAY <br /> 3. PUBLIC FILESIRECORDS RELEASE APPLICATION (PRRAI IS REGIARED. <br /> S RECEIVED <br /> C P�ECT FtLY T E EHO S AF RETURNED THEEXPEN5H OF.11{E APPL CANT•THIS ADDITIONAL E <br /> SERVICE WILL <br /> BY THE EHD STAFF A <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. (SEE EHD POLICY 84-0 ) <br /> 6, q�IIdINAI PUBLIC FRESIRECORDS SHALL NOT Be REMOVED FROM THE EHD PREMISE • <br /> •.• •r.t......r�...r...�'.... DATE- <br /> SIO TURE OF APPLICANT - -... <br /> DATE <br /> SIC, TUBE OF RELEASIND Of FICIAL <br /> FH O 14 (REV 9190) <br /> I - <br /> i <br /> Tnm P.417 <br />