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APR-20-98 13 : 05 From : Tetra ' San Francisca 415ST45914 T-595 P. <br /> 1 <br /> Fx ;7- Lcul ; <br /> y _ 0 �' 7 <br /> 9AN JOAQUIN COUNTY <br /> I PUBLIC HEALTH SERVICES <br /> ENVTRONMSNTAL HEALTH DTVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> I q� <br /> APP ICANT }Cwtat Le�iw, c C' GY •5g1Y <br /> PIiON); NO (�tIC) tl `1L7I <br /> ADD ESS �S ' 4t T'u .c.. ,.. Ccw.c�sao C31%064r ( gAK <br /> AGE CY NAME `( e� � � P[IONE NO <br /> ADD ESS <br /> i <br /> riL { w * Mrtixrex + txxtrxxxtt * t * + ittiti + + r } tt + tt + # + + } xi xitt * : # tt + # t + 4 <br /> FULL . jy (�G SS AUSIRESS NAME / Pj2pGRI1M OR <br /> II FACILITY TYAF. nF . grT .F <br /> t. ul Nr <br /> — b 3ct.�a4 Src • 41'�Ot7 I /3; ways <br /> 1� C3 � <br /> I <br /> xir * xft * W + xxtx + + + + t * # ttkYti } + + + tt } }y # tt } t + t + + tkt } t + t + rxxrxtxxr li ,M <br /> THIS I OTICE IS SUBJECT TO THE REOUIRVAAiENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERV CES/ENVIRONMENTAL HEALTH DIVISION MHAI POLICY #94-007, ORDINANCE CODE OF <br /> SAN �OAOU1N COUNTY, EHD FEE AND SERVICE CHARGic RESOLUTIONS. STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE_ <br /> I - A IMAXIMUM OF M Ujo PREMISE ADDRESSES PER REQUEST <br /> 2 . PUBLIC FILES/RECORDS REVIEW IS BY APPOINTMENT ONLY APPOINTMENTS ARE PROCESS- <br /> ED 8� CALUNG (209)488-3420. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> THR FRIDAY EXCLUDING HOLIDAYS, 8:00 AM TO 12:00 NOON AND 1 :00 TO 4:30 PM . <br /> 3 - A I UBLIC FILES/RECORDS RELEASE APPLICATION (PARA) IS REQUIRED_ <br /> 4 . PL LIC FILESIRECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> COR4CTEO BY THE EHO STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. (SEE EHD POLICY 94- 0071 <br /> 5 , ORIGINAL PUBLIC PILFSIRECORDS SHALL NOT BE REMOVED FROM THE ENO PREMISES. <br /> SIGNATURE OF APPLICANT C.,eCJCAyu�a., " , • + - DATE • Yfzc/gt~' + • ' x • � - - • • - <br /> S1GN+TURE OF RELEASING OFFICIAL DATE <br /> EH 00 14 . IREV 9/981 <br />