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913 ri rl'i Uri G'r:irura- <br /> G� <br /> o4-Li-1997 03=06PI F{+OI TU 1 34 84 Y.02 <br /> esd� P/ <br /> 144, <br /> SAN JOAQUIN COUTiTY a7 " `1 I <br /> PUBLIC HEALT11 SERVICES <br /> ENVIRONMENTAL HEALTH DIVISTON <br /> PUBLIC RECORDS 92LEASE APPLICATION <br /> APPLi[CANT �r�.tn 3�-�� PHONE NO <br /> i ADDRESS <br /> AGENCY NAME PHONE NO <br /> ADDRgSS <br /> ' �*a+rraaxfrrarse+ ra+♦a4x�rirr#*♦+#aarattre,ttteF'�*#+#*a#;tits+tkt*•i*w'#ir <br /> FULL ADDRESS PRQCR.AM_Qk9 <br /> TyZE OF -FILE <br /> 7`- Id�f i�Jf� lat r.. �IS.�C7 n3btfr -7 e <br /> r _ <br /> .��,4i._ �L.�t'.sr�:lr`t �.► m;,?cy _��.�S�p na_' cat���r-r�',[-.i. .3s ass .LIST f,CCll'�t-'•�E _ <br /> ca rc nom. 9 a 1�lSr 6 - "{� LL15Y <br /> _41 �, rT�r=Ltr�. <br /> 071 <br /> Icy,- � dm <br /> -7�i 1�' [ f' "'r7c neva 1r. `Tc�i la r' .It 4i <br /> tl•? <.. <br /> •r *• • rr,►r,ti#aaiaa +*+wsarr#ia,►!#it*#a###t+-rkt#waaai#rat+wit##}a;**# <br /> TN15 NOTICE IS SUBJECT TO *NE REQUIREMENTS fUENTIFIED IN THE PUBLIC WEALTH <br /> SEAVtCES/ENVJRQNMENTAL HEALTH DIVISION IEHD) POLICY Jf94_007. ORI]INANCE CODE OF <br /> SM1 JOAQUIN COUNTY. EHD FEE AND SEAVIC9 CHARGE RESOLUTIONS, STATE WATEF1 COPE, <br /> GOVERNMENT CODE AND THE EVIDENCE C009. <br /> I-. A MAXIMUM OF 101�[ � PREMISE ADDRESSFS PER NEOUEST <br /> 2. P1JI91.IC r=II.CSlRECOIaD5 REVIEW IS By APE9M!_rMgMj PIMLY, APPOINTMENTS ARE PROCESS. <br /> ED BY CAI LING 120914$8-3420. OFnCE HOURS F011 APPOINTMENTS ARE SCHEDULED MONDAY <br /> THAU FRIDAY EXCLUDING HOLWAYS. 8.00 AM TO T 7:00 NOON AND 1:00 TO 4;30 PM. <br /> 3. A PUBLIC FIL1;SIRFCORDS RELEASE APPLICA'T'ION IPFIRAI IS REQUIRED. <br /> 4. PUBLIC FILF.S)RECORDS NOT RETURNED IN T'HE SAME CONDITION AS RECEIVE13 WILL BE <br /> COSR19CTED BY THE E<HO STAFF AT THF F_XAEPJSE OF THE APPLICANT. THIS ADDITIONAL <br /> SERVICE WILL HF BILLED TO THE APPLICANT FOR PAYMENT. ISEE 040 POLICY 94- 0071 <br /> S. ORIGINAL PUBLIC FIL.ESIRECORDS SHALL NOT BE REMOVED FROM THE ENE) PREMISES. <br /> •��� .���a�� �������..a a <br /> ........... s <br /> 7 � <br /> +€ SIGNATURE OF APPLICAPIT ���:� :, �.x��`CATE�/,�!fCa <br /> f Sli;i'IATUAF OF RELFASING OFFSCIAL DATE ^� <br /> FH W 14 IRF-11 91961 - <br />