Laserfiche WebLink
3/-7,1 15:54 -`0 46 1118 ACiE 5 i UCTGtJ' "F'HGE� 0�1 '7,i <br /> SAN JOAQU N COLNTY <br /> f / PUBLIC SFALT3 SERVICES <br /> { 11 EN`VLROIvT' _,ILII FAX. EALTH DWISION <br /> .L PUBLIC RECORDS RELEASE APPLICATIC,-, <br /> APPLICANT Vl _ PHONE NO D " <br /> ADDRESS <br /> AGENCY riArh� �� PHONR NO <br /> III <br /> ADDRESS 11DAfil <br /> Bax <br /> B DP EAD A EN Y D <br /> 7" � <br /> e.c=z�-� <br /> airt It it - Y1 , <br /> � 5 � <br /> ©A - - <br /> T}iJS NOTICE is SUBJfiCT TO TNF REQlZ RE2AF-NTS )DENTMED IN THE PUBlJC HEALTH <br /> SERVICESIEI<VMCA:MENTAL FEALTH DI V7 SI ON (F-IID) POI,CY#924307, ORD)NANCECODHOF SAN <br /> IOAQLIJN COUNTY. E14D FE ,S A.ND SER\'ICE CHP.RGE RESOLUi104S, STATE WATER CODE, <br /> GOVEIL MENT CODE AND ir.E EV1DE.NCE CODE. <br /> I. A },SIt'6?,SU�i OF TEN ;;o} PR-E.+iJSB r-DDRESSF-S PER MQU] ST. <br /> i. PUBLIC F)LESIRECORDS REITIEW ARE BY APP01N'TM ENT O 'LY. APPol)-,MMENTS ARE <br /> ARRAN-GED BY CALLING (=0:);58-0340. OFJICE HOURS FOR APPOINT-NIENTS ARE SCHEDULED <br /> MONDAY THRU P' DAY EXCLUDING HOL]DyYS, 3:00 A.M. TO 12:00 N004N AIND 1:00 P14. TO 4:54 <br /> P.,M. <br /> 3. A PUBLIC RECORDS RELEASE APFUCATION AND A NON-PFFUh'DAQL DEPOSIT OF$'IS-05 <br /> IS }tEQL"IR.ED, DEPOSITS wILL )?E P=7, .';ED TO THF ,kPPLICANT IF THE FILE&'CORDS ARE <br /> ;SOT AVAILArLE WITHJN THE CUST033Y OF TEE EHD. <br /> 4. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. THE BALAh`CF OF —jHE CHARGES ARE 1DUE AND PAYABLE PRIOR TO RF.%7IEV'lSG THE <br /> DOCUMENrrp. <br /> 5. PUBLIC HLESIRECO,RDS NOT RETL.r8,NFD IN T)-R SAME CONDITION AS RECEIYED WILL BE <br /> CORRECTED BY THE F-HD STAFF AT THE EXPF-NSE OF THfi APPLICANT. T33JS-ADDPri0NAL <br /> SFAYICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. ' <br /> b. ORIGINAL.PUBLIC FILFS/RECORDS&}LkL.L NOT BE REMOVED FR <br /> OAS 7IIE FIID pREI+�SES. <br /> SIGA'A 11TRE OP APPI.ICANI' iIt.Q DATE <br /> r <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> ER 00 14 (REV 12J92) <br />