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,r Y <br /> • SAN JOAQUIN COUNTY <br /> r O PUBLIC HEALTH SERVICES ION <br /> 1 <br /> +yAL HEALTH DIMS . <br /> ENVIRONMENT <br /> PUBLIC RECORDS RELEASE APPLICATIO <br /> PHONE NO q1&)5&`(—2200 <br /> APPUCAN'I' C:r-. G �, f I <br /> ADDRESS 23 ` <br /> AGENCY NAX,,� – _FRONS NO Spcvn <br /> M_ <br /> ADDRESS <br /> :as <br /> SLUAPPRM <br /> pA� <br /> a !(r3 Channc� 66 7 2 ' <br /> Fto 5� a3S3v <br /> jjJAS in <br /> (EUr;N ONLY m <br /> _ n Y <br /> wk( <br /> 7 0 <br /> Al- IA i 1A 61-) w <br /> At <br /> /�jE �}j���}y��/�ENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> THI5 NOTICE IS SUBJECT TO <br /> S��CE�g�V�ONMENTAL HEALTH DIVISION (gHD)POLICY#42-007,ORDINANCE CODE OF SAN <br /> JOAQUIN COUNTY, 8HD FEES AND SERVICE CHAR(jE RESOLUTIONS, STATE WATER CODE. <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> 1. A MAXIMUM OF TEN (10) PREMISE ADDRESSES PER REQUEST• <br /> 2. PUBLIC FILESIRECORDS REVIEW ARE BY . APPOINTMENTS ARE <br /> BY CALLING (209) <br /> 4G8-0340. OFFICE HOURS FOR <br /> ARRANGED APPOLNTMENIS ARE SCHEDULED <br /> MONDAY D FRIDAY EXCLUDING HOLIDAYS, 8:00 A.M. TO 12:00 NOON AND 1.00 P.M. TO 4:30 <br /> P.M. <br /> DEPOSIT OF$78.00 <br /> 3. A PUBLIC RECORDS RELEASE APPLICATION ANDANON- CORDS <br /> IS REQUIRED. DEPOSITS WILL BE RETURNED TO THE APPLICANT IF THE FILES/RE ^.f <br /> NOT AVAILABLE WITHIN THE CUSTODY OF THE EHD, <br /> 4. THE ABOVE IDENTIFIED DEPOSIT IS APPLIED TOWARDS THE TOTAL FILE REVIEW <br /> �}THE <br /> CHARGE. THE BALANCE OF THE CHARGES ARE DUH AND PAYABLE PBIQB .r�.. <br /> DOCUMENT(S). <br /> S. PUBLIC FILES/RECORDS NOT RETURNED IN THE SAME CONDITION AS>�CEIYED�� - <br /> CORRECTED HY THE EHD STAFF AT THE EXPENSE OF THE APPI1 u: <br /> SERVICE WILL BE BRIM TO THE APPLICANT FOR PAYMENT. <br /> G. ORIGINAL PUBLIC FILES/RECORDS SHALL NOT BE REMOVED FROM THE MID PREMISES. <br /> DATE <br /> SIGNATURE OF APPLICANT <br /> —3-5 <br /> SIGNATURE OF RELEASING OFFICIAL DATE <br /> EH 00 14 (REV 12/42) <br /> - I <br />