Laserfiche WebLink
• <br /> 173 <br /> -r <br /> SAN JOAQUIN COUNTY <br /> PUBLIC IWALTI) -.ERVICES <br /> ENVIRONMEtITAI, HEALTH DIVISION <br /> PUBLIC REConDS RELEASE APPLICATION <br /> I Pll(7N13 rJU <br /> 1�l7E)12(;:3�; I1+fp{Q,�F OGJ�1tj$[>Rw!/� C.Ef�SiWT <br /> I�CE,rICr (iArtE � r �,,�r�5 l.�+le_ P1�LONR NO 6 53Ek� --- <br /> ADVRESS ----- --- - --- <br /> y + ♦ t♦ r•1 JF 4+ 4 +*** k k A k•r t**t t 4** 4,Ir kr•Ir+4#+ +k k+ 4•4#*t t• t k + k k 4 4 1##i#t t#i t+S <br /> 1=UL,L ALIORESa. BUS N�'lE1 PROGRAM FILE <br /> FAC:ILi'1•Y TYPE OF I✓FE <br /> --H4.3 tYa i }. f ori >•kk Cdli/z�'r►ra �rv�'� Cry-!�c�v6c �r' <br /> e1 - 35.a�. 2r2-�uSr <br /> J111..Nac��`- <br /> {� a_ yHeA-i <br /> Ll 1lbei'&I 1. .1cr?.t_ <br /> n ftr_y'ls�_ 55 <br /> ' 1. rtq /!{j�e C�gp1GC�t�b✓ <br /> Zp1 S�ccl A � ' -- In_ . s�Lcl �- )-� ��2`Lpyl 3S', 1.11 S i` <br /> LSr Y f I�UQcj4 1' -IA' <br /> 1_dl���`! • vUG _1 <br /> Cf• - <br /> 1..�L�lVl�1I� - i✓�j i•i ��.r1�LQN r1er5.,.�'u(�. �yt�l��,T ._. <br /> A, + r t t Y k 4 * ++r 4 k+ t t t+k 4* * * ** k k i k 4 <br /> I'FI1S MOt'IrF Ic SI.)B.)FCT TO THE RCQUiTIfMENTS IDENTMrim IN THE PUBLIC HEALTH <br /> SERVICF5/EtJVIR()r4MENTAL IIr-ALTH DIVISION IEHDI POLICY #94-007, ORGINAticE CODE OF <br /> SAr•I .JC)AC)I.NIJ COUNTY. Rif rFE AND SERVICE CHARGE RESOLIJTIONS. STATE WATER CODE. <br /> GOVERPIMFNT CODE A�10 THE EVIDENCE CODE. <br /> 1 . APAA:fIRAIftA OF iEIV {101 PitEp�11SF. A(7DRESS-S VER RF-UUES 1 <br /> 7. PUFILIC FII_FSJR&( SRITS IIEVIEW IS RY APPOINTMENT ONLY. APPOMNTMENTS ARE PROCESS- <br /> ED RY ('Al I (h1(-, 0-091.1631-31220 orrCF )((711ti5 FOR APPOMUTMFNTS ARE SCI-1170111 FT) MOPIE)AY <br /> THAV F-PIE)AY FXCLUDING HOLIDAYS, E1:00 AM TO 12,00 NOON AND 1:00 TO 4:30 PM. <br /> 3, A PI-jRl I(: FILES/RFCORL'I RF_1_F-ASI: APPLICATION (FRRA) IS REQUItIED. <br /> 4. PURLrt' FILESIP.F( (�((l7� ►1C1T RC TlittrJED IPJ ill(_ 3AMI* Ct)NDITION AS RCCF_IvM'I-) WILL BE <br /> CORHFCTFh RY THE Eii1l S I AFr AT THE FXPF.IItSF_ QF T!•IF AI`i'1.II-ANI i I IIS ADDITIONAL <br /> ;FRVI(-.F wll.[- RE BILLF..1) r(-) IIIF A('113CANr I-OR PAYMENJT (SEF r.HF) POLICY 94 007) <br /> S. ()141(;INAL PVmic rILE`:.'RFt-r)Rr). SHALL 1.1()T F7F PErAOVFT) FROM -ri;c 010 PREyi(SES- <br /> . . . . .... . . . ... ... .. . ..... . . ....... . . . ... ......_......._.......... .� <br /> sIGINIA I UHF OF APPI-ICA14T�e��lr:�r <br /> SIGNATURE OF: RFI FADING OFFICIAL_ —! DATE <br /> 1-1-1 (?O 1'i (II>_v 9/961 <br />