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I S�w TOAQUIN Coulm. ' <br /> PUBLIC HEALTH r, VICES <br /> ENVIROI!7MS*7TAL HEALTH DTVISIOZ7 <br /> l PUBLIC RECORDS RELEASE APPLICATION <br /> PHONE NO D- 3 -2 <br /> .ADD�EtESS a , ---- <br /> AAGBEiCY NAME- -----PHONE�� NO --- <br /> ADIASSS <br /> ,itt;i•tttr#txttxrrtttti ttr+++fewttft*,t,E,r,rr,r*ifat*f*t#,t*r:t:,rx,r::s*ttr* <br /> ULT, ADDK:SS EUSINESS NAME/ PROGRAM OR <br /> 35, fi FACILITY / TYPE QF <br /> - <br /> r <br /> ,fiijE <br /> r 3 O/L�u st R Sy Jl �i d flit��Y` & <br /> u .sem <br /> Ne <br /> 5 5-E AL M41-Mi ,S7! <br /> I <br /> *tirttttt•ktt-►isst:,t�rx***tttt,r+*t,►*,trrx*ttt::�rxf,k+�t,t,rt*kttt,rt*+.,t+ <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIFD IN THE PUBLIC HEALTH <br /> BSER ICES/ENVIRONMENTAL HEALTH DIVISION IEHD) POLICY #94-007, ORDINANCE CODE OF <br /> $AN!JOAGUIN CO JNTY, EHD FEE AND SERVICE CHARGE RESOLUTIONS, S'T'ATE WATER CODE, <br /> POVERNMENT CODE AND THE EVIDENCE CODE. <br /> I <br /> a. A4 MAXIMUM OFPREMISE ADDRESSES PER REQUEST <br /> - --2.-PUBLIC-FIL-E-S/REEORDS REVIEW IS BY APPOWTNIENT ONLY. APPOINTMENTS ARE PROCESS- <br /> FBy CALLING (2+)91468 3420. OFFICE HOURS FOR APPOJNTMENTS ARE SCHEDULED MONDAY <br /> HRU FRIDAY EXCLUDING HOLIDAYS, 8:00 AM TO 12:00 NOON AND 1:00 TO 4:30 PM. <br /> 3. I PUBLIC FILESIRFCORDS RELEASE APPLICATION (PRRA) IS REQUIRED. <br /> 4_ POSLIC FItESIRECORDS NOT RETURNED IN TILE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY THE EHD STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL <br /> SERgICF 1NILL BE!TILLED TO THE APPLICANT FOR PAYMENT. (SEE EMO POLICY 94. 0075 <br /> 5. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> r eFICIAAL <br /> SIGNATURE OF APPLICANT DATESIGNATURE OF REI.EASINO O __DATE <br /> EH 00 14 fREV 9/Eli) <br /> IU10L F.0= <br />