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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEAL'T'H DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT � i 1 En�!�rorr.� Gy a r PHONB NO Cil/6 <br /> ADDRESS /0 /mac. Lci S o.r t v+ C-A <br /> AGENCY NAME PHONE NO <br /> ADDRESS <br /> FL' LE ADDRESS LEAD AGENCY DA <br /> •e Its e; / �/ q/ S" 4 f .1 / - ` ci Z <br /> M'r7 o n .9 <br /> A&(41 <br /> SAC/( C C% f� . ._ L-op 's <br /> stie[� bol k <br /> 7:s►y L�6� -� LCrac4ki Avt Sf <br /> ar �er --,'7 rb u <br /> cz/1 AaCflii 14 , <br /> ero 230 rrt l fi r _ 5-Ak k <br /> lCrr i c`-J it C kev <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC! <br /> HEALTH <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION(EHD)POLICY#92-007,ORDINANCE COD&OF SAN <br /> JOAQUIN COUNTY, EHD FEES AND SERVICE CHARGE RFSOLVnONS, STATE WATER CODE , <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> I. PUBLIC FILES/RECORDS REVIEW ARE BY APPOINT[uIENT ONLY. APPOINTMENTS ARE <br /> ARRANGED BY CALLING (209)468-0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 A.M. TO 12:00 NOON AND 1:00 P.M. TO 4:30 <br /> P.M. <br /> 2. A PUBLIC RECORDS RELEASE APPLICATION AND A NON-REFUNDABLE DEPOSIT OF$78.00 <br /> IS REQUIRED. DEPOSITS WILL, BE RETURNED TO THE APPLICANT IF THE FILES/RECORDS ARE <br /> NOT AVAILABLE WITHIN THE CUSTODY OF THE EHD. <br /> 3: THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL' FILE REVIEW.FEE <br /> CHARGE. THE BALANCE OF THE CHARGES ARE DUE AND PAYABLE M $ TO REVIEWING THE <br /> DOCUMENT(S). <br /> 4. PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY THE HHD STAFF AT THE EXPENSE OF THE APPLICANT. "THIS ADDITIONAL <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. <br /> 5. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BB REMOVED FROM THE EHD PREMISES. <br /> SIGNATURE OF.APPLICANT L DATE ff 117 Z. <br /> SIGNATURE OP RELEASING OFFICIAL DATE <br /> EH 00 14 (REV 10/92) <br />