Laserfiche WebLink
til OO 14 (REV5/94 SAN IOAQUIN COUNTY <br /> PUBLIC IItALTIt 8MVICES <br /> t,NVIRON1VYl!,NTAIL IIEALTII DIVISION <br /> I'UBL1C ktCo"g REUASE APPLICATION <br /> APPLICANT �l r'E1-Q t/I �� 1�J PHONB X10 <br /> ADDRESS <br /> AGENCY NAME 671 PHONE. NO 20 3 9 ' a <br /> ADDRESS I A ) 2L L4i=j:2Z= <br /> s- <br /> F ADDR SS ` x L AG Y DATE <br /> P',� 1 U 3� �'�n �.1 /due. lwellsrcrd (IYLC;) • <br /> o s I.0. &7yz&tjAbk,( — -7-11 <br /> wrra <br /> b�2�/'1U W. C-t zc¢/�n e -• %L='.�!��� Lv /Y1/7'i 3�'�� <br /> IRz 4 Le <br /> �1ac4r,�ll.r ' Ayxrr�ctvL <br /> 71 (1 �cc.o > L.oP <br /> p l?jS /U /6t SOP ( K 136 <br /> 13 S / rl(C LI —�l jk{tUrl Liu li//��1�5 <br /> 6rz4v�'p%-j /r FD T-5 o29 l90 <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION(END)POLICY#94-oo7, ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, EHD FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1. A MAXIMUM OF TEN (IO) PREMISE ADDRESSES PER REQU <br /> 2. PUBLIC FILES/RECORDS REVIEW Is BY APPOINTME T ONLY.`` Ap - <br /> p "ENTS ARE ARRANGED BY <br /> CALLING (209)468-0340. OFFICE IIOURS FOR APPOINTMENTS A�1J(SC116ULED MONDAY TI1RU FRIDAY <br /> EXCLUDING HOLIDAYS, 8:00 AM TO 12:00 NOON AND 1:00 PM TO <br /> 1R�NME <br /> 3. A PUBLIC RECORDS RELEASE APPLICATION (PRRA) IS REQt1r� RM1S <br /> 4. PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDITION As RECEIVED WILL BE CORRECTED <br /> BY TIIE EHD STAFF AT THE EXPENSE OF THE APPLICANT. TMS ADDITIONAL SERVICE WILL BE BILLED TO THE <br /> APPLICANT FOR PAYMENT. (SEE EHD POLICY 94-007) <br /> 5. ORIGINAL PUBLt �FOR S SIIALL NOT BE REMOVED FROM THE END PREMIS <br /> SIGNATURE OF APPLICAN I DATE <br /> SIGNATURE OF RELEASING FMCI L DATE <br /> NO PHS/EIID RECORDS/FILES ARE IDENTIFIED: <br /> nAia: NanFICATION DAM <br /> [RECORDs/FILES <br /> HS/EHD RECORbS/FILES EXIST ON THE ADDRESS(ES) NOTED. YOU WILL BE NOTIFIED WHEN <br /> ARE AVAILABLE FOR REVIEW: <br /> Ata: Rav,s■�e n: Nonnmmw DAre: <br /> �� 11 994 <br />