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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH'SERVICES <br /> ENVIRONMENTAL. FIEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION / <br /> APPLICANT 1/��L OL(�/2 ]IJ PHONE NO—Z/5 OU <br /> of ADDRESS 2g �r'S s ,n ✓ _ 5�'++i L (�_ <br /> ACENCY NAME PHONE NO <br /> ADDRESS <br /> jt+t►++++tt++#rttxr+trr+t*t+i+ x*t#+t++###+t++xtrt++tt**#+##t**t#+r <br /> I <br /> `U ,L ADDRilBS ZIISINgSS NAME1 PROGRAM OR <br /> pACILI TS�PE OF FILE <br /> Fes_ <br /> l <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICE S/ENVIRONMENTAL HEALTH DIVISION (EHDI POLICY 894.007, ORDINANCE CODE OF <br /> SAN JOAQUIN COUNTY, EHD FEE AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1. A MAXIMUM OF jfN JW PREMISE ADDRESSES PER REQUEST <br /> 2. PUBLIC FILES/RECORDS REVIEW IS BY SEPOIN ld NT ONLY. APPOINTMENTS ARE PROCESS- <br /> ED BY CALLING (2091468$420. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 AM TO 12:00 NOON AND 1:00 TO 4:30 PM. <br /> 3. A PUBLIC F(LES/RECOROS RELEASE APPLICATION (PRRA) IS REQUIRED- <br /> 4. PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDYLION AS RECEIVED WILL BE <br /> CORRECTED BY THE EHD STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITfONAL <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. ISEE EHD POLICY 94- 007) <br /> 6. ORIGINAL PUBLIC FILESIRECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> ••M•d lJi••��•JJ J•i J�x#JIftJ•! • /yr/I•IJxJJ•••1.••x•.•���.JJJ^�•��J��• <br /> SIGNATURE OF APPLICANT ( j �,+Iv �DATE�7 <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14 IREV 9/96! <br /> `� Tnrni o rs-. <br />