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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONN ENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT 1 'r f �r�t ip.-arr. �d i PHONE NO ��i 16 7d'[-- Z 1 o <br /> ADDRESS /0 /mac La S /fart=ur c�-f <br /> AGENCY NAMB PHONE NO <br /> ADDRESS <br /> FM-g ADDRESS LEAD AGENCY DATE <br /> 17 <br /> lllldbv—c - i c 5 ra <br /> '.1 i n .1 <br /> 411 4! !, <br /> sAe(i lt f k4 . L o t_ <br /> s�et� 3 S k c.o P . .----- <br /> 7:( tLtiL12ZCGreune.3 :6 Ur-1 IJ <br /> elf.]r1►G s 230 <br /> 0 <br /> Ckecs,y 5fcc�+v <br /> ' I <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 i <br /> JOAQUIN COUNTY, EHD FEES AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1. PUBLIC FILES/RECORDS REVIEW ARE BY APEOINTTMEIj 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 AO - D LE DEPOSIT OF$7$.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 gRIOR TO REVIEWING THE <br /> DOCUMENT(S). <br /> 4. PUBLIC FILESI"CORDS 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 HRLBD TO THE APPLICANT FOR PAYMENT. <br /> s. ORIGINAL PUBLIC FILESIRECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> SIGNATURE OF APPLICANT DATE fl- 1.7" 'F'L <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14 (REV 10/92) <br />