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`_HlA-iFLL X, 17VLV-I lU l�llhl�l. ;" :_Vll r-,-102 <br /> 1 99- 190 <br /> SAN JoAQUIlQ COUNTY. <br /> PUBLIC HEALTH SERVICES <br /> y�RONMENTAL EXALTH DIVISION <br /> PUBLIC "CORDS biELEMF- APPLICATION fq�Et <br /> APPL2'CANT �ICcL� PHONE NO <br /> ADDRESS f <br /> AGENCY NANSE PMNE NO <br /> ADDRESS <br /> lYM#ttf#t�#w.t*##X•iY�FXtrkt#Y#�1tylktt##i'##irk►!''it#*Yttfitt#fiXT'k`t*####.trtit### <br /> BUSYNESS_-NAME/ PROC-R11=M OR <br /> SooFA-TLSTY TYp) _OF FILE <br /> Z —4 Z _ <br /> H ✓. <br /> t,t:ttsyr�rtettft4yritt##�t:hiryl,t#-t##*,Ic#iF,ttitdrir#*ftt#kt#tfi'�ft#�rrt-t#-k-k* twr,r# <br /> THIS NOTICE fS SUBJECT TO THE REQUMFMENTS meNTIFIED IN THE PUSLIC HFALTH <br /> SER"CES/ENVIRONMENTAL HEALTH DIVISION (EHD) POLICY A94-007, ORDINANCE CODE CIF <br /> SAN JOAQUIN COUNTY, EHI?FEE AND SERVICE CHARGE RESOLUTIONS. STATE WATER COLE, <br /> GOV1=RNMENT CODE'AND THE EVIDENCE CODE. <br /> 1. A MAXIMUM OF 10 1'QI PREMISE ADDRESSES PER REQUEST <br /> 2, PUBLIC F1LES1RECORDS REI/I3 1t1 15 BY APPOINTY ONLY. APPOINTMENTS ARE PROCESS- <br /> !ED 8Y CALLING (20S)4693420. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> THRU FRIDAY EXCLUDING HOLIDAYS, 0-00 AM TO 12:00 NOON AND 1:00 TO 4:30 PM_ <br /> 2. A PUBLIC FILESMECORDS FIELEASE•APPLICATION (PRRAJ M REQUIRED.' <br /> 4. Pt.161_IC TqL ESAECORDS NOT RETURNED IN THF SAME CONDITION AS RECEIVED WILL 9E <br /> COR13ECTED BY THE END STAFF AT THS EXPENSE OF THE APPLICANT. THIS ADDITIQNAL <br /> SERV1'Ct MLL BE O LUM TO THE APPLICANT FOR PAYMENT. (SFE EHO POUC`� 94 007) <br /> $. ORIGINAL PUBLIC FTLFSJRECQAOS SHALL NOT ISE REMOVED FROM THE EHD PREMISES_ <br /> w��♦+�tyy•���+►M•�r��f7���i� 'tr iiF��+a+a•♦+•�++•� .��•��a++��Te�+a�•�•�• <br /> SIGNATURE OF AF LICANT / `i DATE I <br /> SIGNATURE OF RASING OFFYCIAL � DATE <br /> EH 00 14 (REV 9196) <br /> TOTAL P.02 <br />