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y <br /> SAN JOAQUIN COUN'T'Y L I f q �I <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DMSION <br /> PUBLIC RECORDS RELEASE APPLICATION 199 <br /> APPLICANT (SIfO 6013L LYIJ M6-TPV—PHONE NO <br /> ADDRESS ;�o R c,3 <br /> AGENCY NAME1,i,{ ,,,,,L4,, �74� PHONE NO <br /> ADDRESS <br /> PILE ADDRESS LEAD AGENCY DATE , <br /> moa- VA v n,e- 5nr,,� <br /> ,5... F+G�Sn1 D 7s,-"p/o -29. G O f� n S ori <br /> .�57 ,UP#aa fir- s-rh-cma'-b'a . 5,57-D 4 v <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTAL HEALTH DIVISION (EHD) POLICY/!92-007, ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, EHD FEES 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 ARE BY APPOINTMENT ONLY. APPOINTMENTS ARE <br /> ARRANGED BY CALLING (209)468-0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED <br /> MONDAY T14RU FRIDAY EXCLUDING HOLIDAYS, 8:00 A.M. TO 12:00 NOON AND 1:00 P.M. TO 4:30 <br /> P.M. <br /> 3. 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 /> 4. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW FEE <br /> CHARGE. THE BALANCE OF THE CHARGES ARE DUE AND PAYABLE PRIOR TO REVIEWING THE <br /> DOCUMENT(S). <br /> 5. PUBLIC FILESIRECORDS 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. <br /> 6. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> SIGNATURE OF APPLICANT DATE • <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14 (REV 12/92) <br /> V"u C�� <br />