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v SAN JOAQUIN COUNTY v <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONA ENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT b2!_L r Cay r "" PHONE NO <br /> ADDRESS L9.3 C?r M to 203A C,�,c�0 c G�AGENCY NAME PHONE NO <br /> ADDRESS <br /> FILE ADDRESS LEAD AGENCY DATE <br /> AAS C.0*-xq3 -3��5 N-zVu,eu 'KI���1, , <br /> l�,as &-fiiw5 Gxocc5b q l31_ <br /> ll <br /> c <br /> Lllli� Tx+dr. k cv�Qje4 . <br /> ?3`15 L). -RlJd <br /> 5?►e11 31?S & . f .s glad <br /> 1- a, + <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMINTA IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION(EHD)POLICY#92-007,ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, MD FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> I. A MAXIMUM OF TEN (I0) PREMISE ADDRESSES PER REQUEST. <br /> 2. PUBLIC FILES/RECORDS REVIEW ARE BY APPOINTMENT QIYAPPOINTMENTS ARE <br /> ARRANGED BY CALLING (209)468-0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 A.M. TO 12:00 NOON AND 1:00 P.M.TO 4:30 <br /> P.M. <br /> 3. A PUBLIC RECORDS RELEASE APPLICATION ANDA NON-UEUNDABLE DEPOSIT OF$78.00 <br /> IS REQUIRED. DEPOSITS WILL BE RETURNED TO THE APPLICANT IF THE FILES/RECORDS ARE <br /> NOT AVAILABLE WITHIN THE CUSTODY OF THE EHD. <br /> 4. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. THE BALANCE OF THE CHARGES ARE DUE AND PAYABLE PRIOR TO REVIEWING THE <br /> DOCUMENT(S). <br /> 5. PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY THE EHD STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL 136 BILLED TO THE APPLICANT FOR PAYMENT. <br /> 6. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> SIGNATURE OF APPLICANT DATE <br /> L <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> Till 00 14 (REV 12/92) 's <br />