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J UIY F�1 'yb kO7.18 H i i •HA xeerr n - - •- - - - .-L- i <br /> 06Past-tt'Fax Note 7671 <br /> —02-194E 08 39F'[1 FROG! s <br /> To r � 'j• l,� From <br /> Co. z <br /> u . CO. <br /> Phones Prune s` <br /> Faz! L r{1 (.r7 --j Fax s <br /> i <br /> SAN JOAQUIN COUNTY 3� <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMEN'T'AL HEAL'YTIT DIVISION <br /> PUBLIC RECORDS RSL24ASE APPLICATION � <br /> C, PHONS NO ' <br /> AFPLYCAor Arn al1a35,pU -ter- 1-MC10� <br /> ADDRESSPRONE NO - v <br /> AGEN&Y RA114E c ti 2( <br /> ADDRQSS ;� <br /> .� ri�ir##'#w11rt###TYtrt##-rt#Y#t# tti�'#;yr;t##tf'f#t*# t tl'##Y#Y#Y#1r 7t#+C#'Ktt•kY# <br /> I <br /> f TLC I11DC}RB$� BU N ;� 11 -E/ PROGRAM OR <br /> FACIL::'['Y TY2E OF FILis <br /> i <br /> Lp� c, <br /> Gi Lou� s P i _ rc is��-s <br /> 95` ! r Ravd. Trac - - <br /> •#: z+� rt3:xJl+et**s�##+rt## t e:#tt,t M+ +r##3�t lrr,v#*t:�rxlr#tk'+'tt##ee�r#z 4# <br /> THIS MOTICE iS SUBJECT TO THE RECUMEMENTS DENTIFIED IN THE PUBLIC HEALTH <br /> SERvICESlENvIRONMFNTAL HEALTIH DIVISION IEHDI POLICY #94-007, ORDINANCE COOE Oa= <br /> SAN 16AouIN COUNTY. EHE) FEE AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOvEi�INMENT CODE AP40 THE EVIbENCE CODE. <br /> 1 , A MAXIMUM OF aft LM PREMISE ADDRESSES PER REQUEST <br /> PUBLIC FILESIRECORDS REVIEW IS By APPOVIN11 T�ONL�{ RPPOWTIVIE TS ARE PROCESS- <br /> TDHBY RU 'R�IOA(N EXCLUD8NG3420.HOLIOaYSC 8:00 AM OE HOURS R12.00 NOONENTS ANDI 00 O 4RE 0ULED-.30 PMMONOaY <br /> I ; <br /> 3. A.PIIIJBLIIt FILES/RECORDS RELEASE APPLICATION (PRRAI IS REQUIRED. <br /> 4. PUBLIC FILESIRf`CORDS NOT RFTURNED IN THE SAME CONDFr10N AS RECEIVED WILL BE <br /> CORRE'_TEQ 5Y THE EHD STAPP AT THE EXPENSE OFTHE APPLICAtdT. THIS A00(TiO <br /> NAL <br /> SERVICE WILL. 0E BILLED TO THE APPLICANT FOR PAYMENT. ISEE E'ri0 POLICY 94- QO7} <br /> 5_ ORtGINAL PUBLIC FiL£SIRECORDS SHALL NOT BE REMOVED FROM THE EHD PREMISES. <br /> .. ...........• •.•..••+•+•••••• ........•..... <br /> SIGNATURE'.OF APPLICANT Z( V►.CL - BATE �I ��SC <br /> r <br /> SIGt*TUkE?OF RELEASING GMCIAL OATS <br /> EH Op 14,(R0EV 919W <br /> i <br /> i <br />