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5-13-1906 4:58PM FROM f NO 20& ase eine <br /> 5� SAN JOAQUIN COUNTY <br /> c, <br /> PUBLIC HEALTII SERVICES <br /> ENVIRONMENTAL EMALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT It eyi n M c K `4 n PHONE NO <br /> ADDRESS <br /> AGENCY NAME Adyoa c+ •o Enyiyon fn'141a( PHONH NO 9 5 6 0�6 <br /> ADDRESS 1$03 W Marc Ln fL-t l} / 5)ocxtomj <br /> FILB AI3DRHSS LEAD AUENCY_ DATE <br /> 1 13S6 N- plVad ra AVe - M- ff n <br /> 1105, N. $rocdwn /1 of . .3 •S SL �Yto <br /> I700 )V. Fro-Wto(t f11/4 . a29 <br /> 3932 11ACI weistr GC' <br /> _ 16115 Shaw Kd. <br /> 1900 Shaw <br /> 140$ 164tv <br /> '4315 E. >tikT*rlo0 3sa 55 <br /> 273T Cln•rov�e� 351 <br /> 3635 ClitroKtIt — <br /> THIS NOTICE IS SUB7ECT TO THE REQUIREMENTS IDENTIFIED IN TRE PUBLIC HEALTH <br /> SERVICESMNVIRONMENTALHEALTH DIVISION(EBD)POLICY 1192-007, ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, EMD FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> I. A MA3QMUhI OP TEN(10)PREMISE ADDRESSES PER REQUEST. <br /> 2. PUBLIC FILESI"CORDS REVIEW ARE BY APPOINTMENT ONLY, APPOINTMENTS ARE <br /> ARRANGED BY CALLING (209)468-0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY THRU FRIDAY EXCLUDING HOLIDAYS, 6:00 A.M.TO 12:00 NOON AND 1:00 P.M.TO 4:30 <br /> P.M. <br /> 3. A PUBLIC RECORDS RELEASE APPLICATION AND A NON-REFUND A$I E DEPOSIT OF$78.00 <br /> IS REQUIRED. DEPOSITS WILL BE RETURNED TO THE APPLICANT IF THE FILES/RECORDS ARE <br /> NOT AVAU J a WITHIN THE CUSTODY OF THE EHD. <br /> 4. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FLLI3 REVIEW FEE <br /> CHARGE. THE BALANCE OF THE CHARGES ARE DUE AND PAYABLE PRIOR TO REVIEWING THE <br /> DOCUMENT(S). <br /> 5. PUBLIC FILES/RECORD.S NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BB <br /> CORRECTED BY THE END STAFF AT THE EXPENSB OF THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. <br /> 6. ORIGINAL PUBLIC PILES/RECORDS SHALL NOT BE REMOVED FROM THE EHD PRHM]SES, <br /> SIGNATURE OF APPLICANT /l t DATE I I Ila% R <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14 (REV 12J92) <br />