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J UIY ell •7t3 107-li3 H i b IA 7CJGYJI /. _ r 1 t <br /> Post-II'Fax Nota 7671 <br /> 06-01-1998 08:39F" FROM <br /> 1b t" le �' From <br /> Phone# <br /> Phone A -4J`7'l,5_(4`F <br /> Fax 0 <br /> V q t ZJ IF"11 <br /> i / Dn <br /> j SAM JOAQUIN COUNTY `. <br /> PUBLIC 14HALTII SERVICES <br /> � ENVIRONMEN'('AC, IiEAL'I'Ii DTV1$Z4I`I <br /> i PUBLIC RECORDS RELEASE APPLICATION <br /> APPLIC�►N ' nrl �I�Q�S �) 'ter f`/�/ICIOII� _PHONR NO <br /> ADDRES17 <br /> S <br /> AGUN&Y NAM pT(4NE NO ' -427 'r? <br /> ADDRISS r 21 <br /> •.x�r`AF9r+►+t'r,rr*r*ir*�r�,rr*t•k*irtt#tort'��w**•ttrf�,t**,t**#�*�t*�'*ir*seirkt�lrtt*� <br /> f •. <br /> BUSXNESS PROGRAM OR <br /> FACIL'_'I TYpS- nE _ FIL <br /> 1 Ls'S sco— <br /> _ _ z S>° -- c Q"', -f_ t2l2Ci�Ca�`�`'�� <br /> . tk <br /> •� (�- (�o�-l��[III✓]rY1!°�1�.7. fDC..�ra�,-r'� [� _ _ .�i i--N�i !1 <br /> ?i !zr�tr+#C xYr7t'*�*'k�#�►*arra+Tr-1rt:�t*rt#�-rt+tt#*t#**ttt*•k`k*'N*,tt,t* tr�r#x,fr* <br /> THISTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICESIENVIRONMENTAL HEALT}i DIVISION IEHDI POLICY #94-007, ORDINANCE CODE OF <br /> SAN JQAOUIN COUNTY, EHD FEE AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVEI4NMENT-CODE AND THE EVI©ENCE CODE. <br /> 1. A MAXIMUM OF TO L4l PREMISE ADDRESSES PER REQUEST <br /> I <br /> 0 LY APPOINTMENTS ARE PROCESS- <br /> 2. PUALIC FILESIRECORDS REVIEW IS BY APpOiNT�I jT( <br /> ED BY �ALCWG (2091468-3420. OFFICE HOURS FOR APPOINTMENTS ARE SCHLOULED MONDAY <br /> THRU FRIDAiY EXCLUDING HOLIDAYS, 8:00 AM TO 12:00 NOON AND 1;00 TO 4:30 PM. <br /> 3. A P�JBLit. FILES/RECORDS RI&LEASE <br /> APPLICATION (PARA) IS REQUIRED. <br /> a. PUBLIC FILES/RECORDS NOT Rl:TURNEC}IN THESAME CONDITION AS RECEIVED WILL BE <br /> CORREGTEIJ BY THE END STAPP AT THE EXPENSE OFTI HE APPLICANT. THIS AD <br /> OITIOPtAL <br /> SERVtQs WIt.L BE BILLET)TO THE APPUCANT FOR PAYMENT. IEEE EHD POLICY 84- 0071 <br /> S. ORIPINAE_ PUBLIC FILESIRECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> •*wrwl•rrs:aa����rss►a Isar asar.rsstwaa�rarra �r��i���i��iar aa.►aaaaaaasa r��rr <br /> SIGNATURE:OF APPLICANT��' <br /> OATS <br /> SIGN) TUkl.OF RELEASING OFFICIAL DATE <br /> EH 00 14,4EV 91961 <br />