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04/11,119C7 1?:10 3039800089 PINYON alVIROFOVEMTAL P-GE 02 <br /> —4sa.,un Ofmx l0 <br /> Pfokwt AsNemx , <br /> - IT...r 1'"039600089 P.a2 <br /> PV'""EMVlRONMENTAL ENGINEERING <br /> -RESOLmCM INC- �l <br /> C9�)flea-6200 <br /> I=S.Yukon Shot �� /�2;✓�.zuJ <br /> SUM 320 <br /> wzg <br /> SAN JOAQUIN COUNTY -G, 7& <br /> ptiHLIC HEALTH SERVICES <br /> E MENTI4L HBALTH DIVI3IOM <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> AP P L I CANT';! <br /> ADDRESS PHONE NO <br /> ACENC'. NAME PHONE l�TO <br /> ADDRESS <br /> ♦tw�tt#yyt#•kitr,►#wt}7t+F***##i•wtw#w4ttiryy*t,lttt}ttrrr <br /> ttw�Mwlt•4yywt•wi <br /> FULL A=RESS USI g NAME/ <br /> TYPE OF ETIP <br /> 477 r <br /> CT f <br /> reL <br /> ftp A <br /> T'S,� �.� <br /> C Z <br /> � � tA.C�o <br /> , .Z° Cno��a ra,a �I r3S1/�FJI <br /> C <br /> l��VTf '`7 Gt *ZA')M!:,n-r Z� 0� <br /> t4 t1'1• *♦tttt#ti*tr♦w}}4r*t*Atttwt#f#4't tits tl}i w}t tit i}ty ti;,►}4}i** <br /> TNI$ NOTICE IS SLIB.IECT TO THE RECUIREMENTS 10ENTIFIED IN T145 PUBLIC HEALTH <br /> SEPVtCC-S/ENVIRONMFNTAL HEALTH DIVISION (EHO) POLICY 194-007, ORDINANCE CdOE or. <br /> SAN JOAQUIN COUNTY. EJHD FEE AND SERVICE CHARGE RESOLUTIONS, STATE WATEi4 COpE, <br /> GOVERNMENT COLE AND THE EVIDENCE COQE. <br /> 1,+ A MAXIMUM OF I1 LIQ PREMISE ADDRESSES E'ER RE(3UE:Si <br /> 2. PVSL1C FILES/PtrzCORDS REVIEW IS BY AMORITNIENT_ONLY, APPOINTMENT$ ARE RROCESS� <br /> ED BY GALLING (2091468-3420, OFFICE HOURS FOR APPOINTMENTS ARE SC14EDULED MONDAY <br /> THRU FRIDAY EXCLUDING HOLIDAYS, 8:100 AM! TO 72:00 NOON AND 1;00 TO 4:3Q PM. <br /> 3. A PUBLIC FILES/RECORDS RELEASE APPLICATION (PRRA) IS REQUIRED_ <br /> 4_ PUSLJC FILESIRECORDS NOT RETURNED IN TRE SAME CONDITION AS RECEIVED WILL 6E <br /> CORRECTED 9Y THE EHO STAFF AT THE EXPENSE OF THE APPLICANT- THIS A00MONAL <br /> SERVICE 1MLL 8F BILLED TO THE APPLICANT FOR PAYMENT. (SEE FHO POLICY 94- 0071 <br /> 5. ORIGINAL PU8LIC FNLES/RECORDS SHALL NOT BE REMOVED FROM THE END PREMISES. <br /> SIGNATURE OF APPt1CANTS4 �, , „ V4Ar <br /> , � r� <br /> SIGNATURE CF RELEASIMG OFFICIAL DATE <br /> Fri 00 14 (REV 9196) <br />