Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE REQUEST FORM <br /> INDIVIDUAL N a.S �C`�L PHONE <br /> ADDRESS - �/C c <br /> AGENCY NAME PHONE NO <br /> ADDRESS <br /> FILE ADDRESS ITAD-BNFORdEMENIT DATE OF <br /> REQUEST <br /> t ( 1 �lJa r-ra u� o4-AC4 <br /> I C.hoo 1 L-0A-L (il ST (_es SHm �e /'�$u i <br /> � o r- T.�• 0 'p <br /> i <br /> 1 <br /> i <br /> San Joaquin County Public Health Services Environmental Health Division files are considered public records <br /> except for certain documents identified in the Government Code and the State Water Code. <br /> Requests for public records or file reviews are subject to charges established in San Joaquin County Rules and <br /> Regulation Environmental Health Permit Fees and Services Charges. <br /> i <br /> Charges for records or documents requested by subpoena duces tecum are subject to changes established in <br /> the Evidence Code. <br /> Photo copies of public documents are subject to Public Records Policy#91-001. <br /> SIGNATURE OF REQUES'T'ING PARTY It I <br /> DATE <br /> SIGNATURE OF RELEASING OFFI DATE <br /> EH 00 14 (REV 3/91) <br />