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' 07 24 '95 10 35 1 P.3 <br /> Fil 00114 (REV SAN JUAQUIN MUM'�0 <br /> PUnuc 11EArLT11 SERVlC S <br /> ENVIRONMENTAL tMAL111 DIVISION q a <br /> PUBLIC RECORDSjKLE ,E APPI„�CATION Z, <br /> � <br /> .1 � >�Ppl�4d <br /> ,APPUC� m A 1 P-CLa i (�xcSc►p a�e 5_PHONB NO yD e- y TA -d A G A <br /> ADDRWS� fo 1 N r;r t S� St�''��•3� ��� <br /> AGENCY NAME .� J'e 51m PHONE NO <br /> ADDRESS <br /> i <br /> FILE ADDRESS LEAA AM= DA <br /> Qv <br /> s <br /> _ I <br /> I _ <br /> 77•!15 N"r-p- Is sumacI' 7'O TME REQUIREMENTS IDEN-nF1217 IN THE PUBLIC HEALTH <br /> smtvICL•wENVIRONMWTAL HEALTH DIVISION (041))POLICY A'94-007, ORDINANCE COPE OP SAN <br /> .IOAQUIN COUNTY, END FEES AND SERVIC13,CliARGII RMOLtMONS, STATS WATER CODE. <br /> OOVE"ENT CODs AND THE SvIDENCE CODS. <br /> I, , A MAX)Mt)M OF T15N (10) M &ML2E ADDA=W PER WUrZT. <br /> �. PUALIC FIL MRSCORDS REVIEW 18 B7 APPOINT7I�GKI'ONLY. ATPOIt�TMSNIi A¢a wRRANQSb SY <br /> CALUNd (209)468-0340. OFMCS HOURS P?R APPOB+[MM-Ta ARE SCHBOULAb MoNDAV TIIAU f-JUDAY <br /> EXCLU"NG HOLIDAYS, 8:00 AM TO 17:00 NOON.AND 1:00 rM To 4:30 rhi. <br /> 3, A Punic Racvi<rn Aeumx ArrucAvoN (PRRA) Is RaqUUtM. <br /> t <br /> i <br /> 4. Ij1m- uc FILlS&REC.ORDS Nair itrry r;v U4 i la SAME COMOMON M Rscsivao wiLL n cokAEcraD <br /> BY TI16 EHD STAFF AT 711E IsXMMS OF T116 AFYLICANP. T11M X=ttlaNAL crltVICS W" az aLLL8D To Tim <br /> APPLICAI;T FOR PATMANT. (S66 EHD Poucy 94-0.07) <br /> 5. C RJOINAL PUBUC FILESIARCORDS SHALL N BMovSb ywm Tur.EHD FRET mEs. <br /> SIGNATII�RH OF APPUCANT DATE �O <br /> SIGNA'RIRkOrP.M.SAS1Nd Or-FICIAL _ DATE <br /> I' <br /> No PHS/R90 R6ICOR)aln,L= ARE IDENTIF119n: <br /> Q1rh I 1t>w►�rr, l4rwe.+.rr>,arr , <br /> PJJSIEi L) Rworbs/F1LM E CLIT ON axe ADDR050s)NOTED. YOU WILL BE NQTMKD wil" <br /> � , �Vl�l�1�Ilfl1l B1tvtEK: r <br /> Int <br /> twm ' <br /> TOTAL P.®2 <br />