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SAN JOAQUIN COUNTY � <br /> PUBLIC HEALTH SERVICES <br /> EINVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT i�Sc'>-� PHONE NO i/% ' ��' ft•'lc% <br /> ADDRESS <br /> AGENCY NAME f IG�•' /".er.:lz�t. <fvs r/�i.�/� PHONE NO 71,1 C4}; %7 <br /> ADDRESS A-h-, <br /> t <br /> I <br /> FILE ADDRM ( LEAD AGENCY DATE <br /> �) yy�llri..�► /1 J��� ,��� ��a,;feC�t �rr�kf��j- ,�/'�s- u.S7-� /P..�cz� GliiC.c,�„/r <br /> , <br /> THIS NOTICE IS SUBIR <br /> JECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBUC HEALTH <br /> SERVICE4/fiNVIRONMENTAL HEAL'T'H DIVISION(EM)POLICY#92-007.ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, MM FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE. <br /> GOVE�NT CODED THE EVIDENCE CODE. <br /> 1. PUBLIC FILES CORDS REVIEW ARE BY APEOIMTMENT ONLY. APPOWTMENTS ARE <br /> ARRANGED BY CALLING (209)465-0340. OFFICE HOURS FOR APPOQ`ITA[ENTS ARE SCHEDULED <br /> MONDAY I U FRIDAY EXCLUDING HOLIDAYS, 5:00 A.M.TO 12:00 NOON AND 1:00 P.M. TO 4:30 <br /> P.M. I <br /> Z. A PUBLIC RfiCORD3 RELEASE APPLICATION AND A - DEPOSIT OF$7 :e 3'-o'c� <br /> IS REQUIRED. DEPOSITS WILL BE RETURNED TO THE APPLICANT IF THE FILE MECORDS ARE <br /> NOT AVAILABLE WITHIN THE CUSTODY OF THE ORD. <br /> 3. THE ABOVE IDENTIFFEED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. THE BALANCE OF THE CHARGES ARE DUE AND PAYABLE FRIG TO RBVIfiwING THE <br /> DOCUMENT(S). <br /> 4. PUBLIC FILES CORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> CORRECTED BY THE am STAPP AT THE EXPENSE OF THE APPLICANT. IMS ADDITIONAL <br /> SERVICE WII.L BE BU.LED TO THE APPUCANT FOR PAYMENT. <br /> S. ORIGINAL PUBLIC FM/RECORDS SHALL NOT BE REMOVED FROM THE MM PREMISES. <br /> SIGNATURE OP APPLICANT "r �,- Y� DATE e 2 Y -yam <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14 (REV 10/92) <br /> �/P-e ll <br />