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w • SAN .IOAQUIN COUNTY <br /> I'lljum' 111FA1J11 SERVICES <br /> E.NVIR(INRIFINTAL 111FAIM11 DIVISION <br /> PU111,IC R1?I 'OItl)S RELKASN; APPLICA'T'ION <br /> APPI.ICAN'I' LA _�J4 /� ' ��^`_ -'�-�-SU PHONE NU ICj1(<� Str��7ZcD <br /> AI)1.)RI15S--L:P3 mrmrrCz C✓,5 1--5 ^n.O �Z-r A �tS`dIS <br /> AGENCY NAME--_ __—.— .---PIIUNE NO <br /> AUURF.SS _—._ _ <br /> f.1LG AUDRtSS LEADAGENCY D <br /> q T�lli c_ w�s 1�.r—....-- ----- E x-1944 — <br /> Zcc�S Ylcu a Dr _—------ --- o JOAQUIlyLONP!#Y- <br /> 2 3z(-1 Y V r. _..----- HE LTH cProU4B1 S <br /> r>Y-. „- ENVI@ONMENTAtHEI{ <br /> LTH DIVIS1nN <br /> I,q o c4 LAD <br /> ww-(�----- <br /> I. 33 <br /> T'IIIS NO'I)CF IS SIIB.IF(?I' 'I'O 'I'Illi RF.(?(11REA11 NTS IDENI-IPIED IN 111E PUBLIC HEALTH <br /> SERV ICF,S/ENVIRONMENTAL ITFAI TII DIVISION (r,111)) POLICY N92-007,ORllINANCF CODE OF SAN <br /> JOAQUIN COUNTY, ERI) FERS AND SFRVICF CHARGE RFSOw-nONS, S'PA'TE WA'T'ER CODE, <br /> GOVERNMENT CODE AND TIIE FVIDUNCE CODE,. <br /> I. A MAXIMUM OF TEN (10) PREMISE ADDRESSES PrR REQUEST'. <br /> 2. 1'UI1L1C FII.,ES/RFC'ORI)S REVIEW ARI; BY APPOIN-1-MENT ONLY. APPOINTMENTS ARE <br /> ARRANGED 13Y CALLING FFICF <br /> E SCIIEDULFD <br /> MONDAY 1RIJ FRIDAY F.XCI.,II IN<^)IIOIJDAYS, 8:M ASR <br /> M IO 12:00 NOON AND L <br /> 700 P.M. TO 4:30 <br /> P.M. <br /> �. A I'lJf)I,IC RFC( RIi1,17ASP APPI.ICA-IlON AND A NON-REFUNDABLE DEPOSIT OF$78.00 <br /> IS RFQlARFD. C,RFC I'I;S WII.1, Ili? RI 1.11RNp) 1.0 111E APPLICANT IF 'IIIF FILES/RECORDS ARE <br /> NOT AVAILABIJ3, WI.1.11IN TllF ('IJS'I'VI)Y (?F'1'llli I IIb. <br /> 4. TIM, ABOVE IDEN-1.11.111I? Dlll'OSI"1' IS APPLIFWI-OWARDS 'I'liF TOTAL FILE REVIEW FEF <br /> ('l1ARGli. 11111IiAL.ANCIi OF'1'llli t'IIAR(IfiS ARE Ul)fi AND PAYABLE, PRIOR '1'O RFVIEWING 'fRF <br /> I)OC(1 M FN'I'(S). <br /> 5. PUBLIC 1'l1,liS/Rl;VORDS NOT RIN I IRNF.I)IN 'I IIF SAM:CONDITION AS RFCEIVFD WILL BE <br /> ('ORitr( I'IiD TTY 'illr tam SUAFP AT -I Ilr i?)tr INSI? UI, 111: APPLICANT. 1-111S ADD1-110NAL <br /> SERVICE WILL I" IiILLrI)1WHIF APPI,1('ANI' FOR PAYMENT. <br /> G. ORIGINAL 1'IJBLI(: 1'lLI'sS/ItI (, I)S SIIALL NOT Br REMOVED FROM 111E EIID PREMISES. <br /> _.. - - — - ---- DATE SZ a <br /> �\ SIGNA'IURI; OF AI'PLI('AN'I' . <br /> -- - <br /> 1\ <br /> SIGN ATI lit 1?OI'111(I,ISASING OFFICIAL, _ DATE —_- <br /> 1911 OO 14 (RFV 17/92) <br />