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t-E6 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH_ SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> P � . 'M�cQE PHONE NO "Y� cJ3'Z-1 <br /> APPLICANT c�'"ZE <br /> ADDRESS '2Zra' LAC�rnN. AD GoG`'cc.:rt CA "�7T\S <br /> AGENCY NAME PHONE NO <br /> ADDRESS <br /> FULL ADDRESS BUSINESS NAME PROGRAM OR <br /> S`ra FACILITY TYPE OE FILE <br /> co•�z �i <br /> "' 13Z� ALCM-¢� 'T�vci�.��.`•C.: c�:,. cn:r\w�z�c;..; ���`5f ' �. <br /> ,.. Gc�..L?{>L. `c4A`.�U•� R� LLN�-3'�:� 3G0 l'��DG °o Il �� -�'/ `./:_ <br /> •TQAcv Pc:`\CE PAC<1..�"TY 4 uS'T j,�3�T <br /> -�"�NF�`AN �C.Aq _FL'E::iCki CAmP 'Mca.':\EQ ci- MotJ\eQ.c�Fcc\`L . 'ST <br /> CAM\t')P'7 iJ <br /> c AvE MA01 Gam( �GCLiNG -LCw�Q. C-�: wI? CIU-� <br /> ��Z . <br /> •J' \Y'j0 cV J\tNC.�A�� � <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION (EHOI POLICY 494-007, ORDINANCE CODE OF <br /> SAN JOAOUIN COUNTY, EHO FEE AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1 . A MAXIMUM OF TEN (10. PREMISE ADDRESSES PER REQUEST <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 /> 3. A PUBLIC FILES/RECORDS RELEASE APPLICATION (PRRA) IS REQUIRED. <br /> it, 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 EHO POLICY 94- 007) <br /> 5. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE EHO PREMISES. <br /> ..... . ................................................ <br /> . .. .. .............. <br /> SIGNATURE OF APPLICANT .i ..� �� DATE IA <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14 (REV 9/961 <br />