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[L—L:�—I`J'}.7/- y=YJUHrvI ". p'.' .JaPr..>o • ...._.......- ...... �w .. � _. ._ '�� <br /> SAN JOAOUIN COUNTY <br /> C ` f PUBLIC HEALTH SERVICES <br /> (3JS £NVIROMIENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT PHONE NO^ <br /> ADDRESS. _ <br /> AGENCY NAME��mG✓_,[f!�� PHONE NO <br /> ADDRESS <br /> FULL ADDRESS BUSINESS NAME/ PROGRAM OR <br /> FACILITY TYPE OF FILE <br /> / - 1 L) <br /> 9 3 tom( fz 0C1d"L' js aG �G,65 <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBUC HEALTH <br /> SERVICESIENVIRONMENTAL HEALTH DIVISION (EHDI POLICY 094.007, ORDINANCE CODE OF <br /> SAN JOAQUIN COUNTY, EHD FEE AND SERVICE CHARGE RESOLUTION$, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE, <br /> 1. A MAXIMUM OF TEN 5101 PREMISE ADORES SES PER REQUEST " <br /> 2. PUBLIC FILES/RECORDS REVIEW IS BY APPOINTMENT ONLY APPOINTMENTS ARE PROCESS- <br /> ED BY CALLING (2091468-3420. OPRCE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 AM TO 12:00 NOON AND 1:00 TO 4:30 PM. <br /> 3. A PUBLIC FILES/RECORDS RELEASE APPUCATION (PRRAI IS REQUIRED. <br /> 4. 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 ADOIT(ONAL <br /> SERVICE WILL BE BILLED TO THE APPLICANT FOR PAYMENT. (SEE EHD POLICY 94- 007) <br /> S. ORIGINAL PUBLIC FILESIRECO S SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> SIGNATURE OF APPLICAN DATE L <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14 (REV 9/981 `" <br />