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SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENV.[R <br /> ONNORqTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> l• ;: ` <br /> APPLICANT PHONE NO �� -- I�j L+S <br /> ADDRESS <br /> AGENCY NAME e,,r PHONE NO - <br /> ADDRESS - <br /> FILE ADDMS LEAD AGEN Y DATE <br /> D i <br /> D 3 ` VED <br /> ` <br /> AN '1'Y <br /> -' P1 IBLIC-klEN- i4 6ERVi(:ES <br /> IVISION <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS YDENT"ED IN THE. PUBLIC HEALTH <br /> SERVICES/ENVIRONMENTALHFALTH DrVISION(EHD)POLICY#94-007, INANCE CODE OF SAN <br /> SERVICE CHARGE RESOLU'TIONS,ST'ATE WATER CODE, <br /> JOAQUIN COUNTY, E>`ID FEES AND <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1. A MAXR,[uM OF TEN (10)PRE2vWEvADDRESSES PER REQUEST. <br /> 3 <br /> 2. PUBLIC FILES/RECORDS REVIEW IS BY A-110MMaNIO APPOINTMENTS ARE ARRANGED BY <br /> CALLING (209468-0340. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY THRU FRIDAY <br /> EXCLUDING HOLIDAYS, 8:00 AM To 12:00 NOON AND 1:00 PM TO 4:30 PM. <br /> 3. A PUBLIC RECORDS RELEASE APPLICATION (PRRA) IS REQumED. <br /> 4. PUBLIC FII.ES/RECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WII.L BE CORRECM <br /> BY THE E 4D STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL SERVICE WILL BE BILLED TO TIM <br /> APPLICANT FOR PAYMENT. (SEE EHD POLICY 94-007) <br /> 5. ORIGINAL PUBLIC FH-ES/RECORDS SHALL NOT BE REMOVED FROM THE EHD PRE(v(IS0- <br /> SIGNATURE OF APPLICANT DATE <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> No PHS/EIID RECORDS/FR FQ ARE IDENTIFIED: DA <br /> DA= RFVMW o wr: <br /> PHS/E ID RECORDS/FILES E3 EXIST ON THE ADDRESS(ES) NOTED. You wn.L.BF-NOTIFY "EN <br /> REcORDSIFuxs ARE: AVAILABLE FOR REVIEw: <br /> UAMM Ravmw=m NamfranaN DAM fE <br /> EH 0014 <br /> JUN ,9 1994 � <br /> I <br />