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10/21/1994 15:44 5104632559 ATC/DEI SFC BR 75 PAGE 02 <br /> Ell 00 14 (REV S194) SAN JOAQUIN COUNTY 7,J, <br /> z OLIC 111Ax"c 91XVICE,S <br /> ENVIRONMENTAL RP.4,LTlI DIVISION Z4,�b J Ll <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT O^J P SH r arJ PHONE NO <br /> ADDRESS Q�t2rZ lafilrK�l�11t-, � <br /> AaQNCY NAME _ ATc ��v� nn �vr�t_ i PHONE NO <br /> ADDRESS <br /> klE ADDRESS �.�iAX?AGENCY DA <br /> o -y &lle- �}vE. _.11,3,ew�,raesy� 47— <br /> 77 !l Ti"I,e,U74rJ Ro. C-nn.-mr�jmr) <br /> m 7&o_. -7*o eNYbYJ RD, �yhr�aJ SAff �ibyi— <br /> /fy4 hmm-f4e L�►1. (1lnowtib SFiT.a 1�L �,oC[a lN� <br /> �'�S f+sRwr6C C.RS S'�T.wu 5i ice' 07� ' <br /> ® Q r+iu) cat�e.e o!s yAer��le Gr11, A��O :,272 <br /> l� <br /> "wtW SACrO lam, - Gu108wr" ink <br /> `v P�.�rf of o4�r�e o swriy .4 T <br /> lois Hn.+e.»�2 cn/, <br /> THIS NCI ICE 19 SUIDSCT TO THE REQUIU"ENTS IDENTIFIED IN THR P(5[1LIC HEALTH <br /> SEP VICES/RN VIRONMF,NTALHBALTH DIVISION (EHD)POUCY ow-OM,OPJWNANCE CW8 OF SAN <br /> JOAQUIN COUNTY, EMD FEES AND SERVICE CHARGE RISLUMNS, SPATE ;WATPA CODE, <br /> GOV6RHMFNT CODE AND 11111 MDENCH CODE. <br /> 1. A MAximum OF TEN (10)PRmnE AbDRmu PFA REQUFiST'. <br /> 2. PUBLIC PILES/RECORM REVIEW IS BY APPQINTmmT()Nt Y. APPon'rlumm ARE ARMAN010 MY <br /> CALIJNr; (209)"84)34D. OPr1ce IICKIRS MR AI`P0lWrmZNTS AaE 2CR9DUL4n MONDAY T11RU PRIDAY <br /> EXCLUDING HOUDAYS, I-W AAI To 12:00 NOON AND 1:00 Pf4 To 4:30 Pm. � <br /> 3. A PUBLIC RECORW REIJIASu APPLICATION(PRAA)is REQLIWBD. <br /> 4 Pubuc FIL.EVIMCORIDS HOT mVAMtD IM WE SAME CONDMON AS RSCENPD WILL tr8 CVRRBcTSD <br /> NY T116 END STAFF AT THE EXPENSE OP THE APPLICANT. TIfO ADDrMNALL SCRVICE WILL )'K ajI I TO T110 <br /> APPLICANT FOR PAVMMr. (992 END POLICY 94-Qn ` <br /> i <br /> 5 ORIGINAL PUauc FILESIRECORDS SHALL mar k6 kemov8U Fxom THF BHD PREMI rIs. <br /> SIGNATURE OF' APPUCANT 4 DATE /4 —,71f9Y <br /> SIC3NATURI?0PROLEASINO OiTI©AL DATE <br /> NO PFISIEHD ALcMowFILFS ARE IDgKTIFIED: <br /> Mn 1ury�w rr tbwar�r,+i AM• <br /> PN,SIFHU RaCMM/Fn-#1 "OT(M THE Anbk63!(E!)NCr FD. YOU WILL BE NAMED WHOM <br /> RK0*D /I tLVS ARE AVAILAWS 1+pIR RtVWW: <br />