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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> r <br /> c", -2 <br /> APPLICANT , �. /p PHONE NO '71 > , U <br /> ADDRESS '/P/ <br /> AGENCY NAME I// c2 .v` t PHONE NO <br /> ADDRESS <br /> ***************************************************************** <br /> FULL ADDRESS BUSINESS NAME/ PROGRAM OR. <br /> FACILITY TYPE OF FILE-- <br /> L t;l <br /> I- <br /> ..`•b< <br /> I <br /> I <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION (EHD) POLICY #94-007, ORDINANCE CODE OF j <br /> SAN JOAQUIN COUNTY, EHD FEE AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> I <br /> 1 . A MAXIMUM OF TEN (10) PREMISE ADDRESSES PER REQUEST j <br /> i <br /> 2. PUBLIC FILES/RECORDS REVIEW IS BY APPOINTMENT ONLY. APPOINTMENTS ARE PROCESS- <br /> ED BY CALLING (209)468-3420. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 AM TO 12:00 NOON AND 1:00 TO 4:30 PM. <br /> I <br /> 3. A PUBLIC FILES/RECORDS RELEASE APPLICATION (PRRA) IS REQUIRED. <br /> I <br /> 4. PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY THE EHD STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. (SEE EHD POLICY 94- 007) f <br /> I <br /> 5. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. 4 <br /> +a++sa+++sa*+++ss+a++a ♦�++�++s�++�+++;++t ♦+a+++++++++++++♦ +tt+++ts+++++++ <br /> SIGNATURE OF APPLICANT D T <br /> � A E ,7 / <br /> C, <br /> SIGNATURE OF RELEASING OF ICIAL l v'.�>.(<4 �p L��"� �J DATE <br /> EH 00 14 (REV 9/96) <br /> i <br />