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qs <br /> SAN JOAOUTN COUNTY , <br /> PUB[,IC IIFAI,I'II SI?RVICPS <br /> FNV.IRONMENTAL III?ALTII DIVISION <br /> PUBLIC RECORDS RELEASE APPLICA'T'ION <br /> I CANT G• O IL2�f�t- _ PHONE NO y7<i <br /> /�1)I►R(�,^-,S -- l-)� 6L A � LTJ � � o ��_'!"__1 �f�- <br /> Ar;RNCY NAME PIIUN No <br /> ADI)RFSS <br /> k k k k k* k k k k k k k k* k #* k * k k * * k k k k k k k # ***'k k#* k k <br /> I3US INESS_NAME/ PROGRAM OR <br /> i'ULLAllURL'SS. TiulL' OF 1"1LC <br /> IV 7Z__ ULZv <br /> k * k k k k $ * k k *** * *#** * #* # ** ** # <br /> TI-1173 NO TICE IS SUBJFCT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HFALTH <br /> SFRVICFS/ENVIRONMENTAL_ HEALTH DIVISION (EFIDI POLICY #9,1-007, ORDINANCE CODE OF <br /> SAN JOAOUIN COUNTY, EHD FEE AND SERVICE CHARGE RESOLUTIONS, STATE WATER CODE, <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> ----' !SE ADDRESSES PER REQUEST <br /> G cokv A.O'LEARY 2419 476-290H <br /> vI IiPRr•.SII,FNT 209476-'2960 FAX IS BY APPOINI.MENT_ONLY.. APPOINTMENTS ARE PROCESS- <br /> 1 �I srRIAI PROVURTICS I'I(--F HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> 'S, 8:00 AM TO 12:00 NOON AND 1:00 TO 4::30 PM' <br /> kSE APPLICATION (PRRA) IS REQUIRED. <br /> COMMERCIAL <br /> C. commrRClAl 1DrlirrringSolutionsThmugh TURNED IN THE SAME CONDITION AS RECEIVED WILL BE <br /> RI'AI.Es i,% F.GROIT INC <br /> 1776 WFSr MARCH I.ANI /Aun!Knowledgeu:Ifre,ri.1P THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL <br /> Surrr•. 1711 <br /> S'11WKION.C'Ao52n7-645O IDROKI'RA17FSPRVICES 'PLICANT FOR PAYMENT. ISEE END POLICY 9`I- 007) <br /> 5. ORIGINAL PUBLIC FILES/REC0R111\\\0_S-$.HALL NOT BE REMOVED FROM l-HE EHD PREMISES. <br /> • s • • ♦ • ♦s e s+ •s • e + s e e e s ♦ • •♦ • •.�J•y�eye e a e e e e s s ♦ s e ♦ ♦ s e s • s a a e s s • ♦ . . . ... s s e w e e! s e• e e <br /> DATE - <br /> SIGNATURE OF APPLICANT � <br /> SIGNATURE OF RELEASING OFFICI — <br /> DATE-5 <br /> E11 00 14 (REV 9/96) <br />